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Pharmacy benefits

For Medica Prime Solution® Enhanced w/Rx 2 (Cost) members

How to check drug costs

Call us to get information on specific drugs available with your plan.

8 a.m. – 9 p.m. CT

Ways to fill your prescription

Prescription support

Get extra help paying for your prescriptions (Low-Income Subsidy)

Contact any of the organizations below to see if you qualify for extra help paying for prescription drug premiums and costs. Click on your state Medicaid office to find contact information.


Contact information


TTY: 1-877-486-2048


24 hours a day,
7 days a week

Social Security Administration

Contact information


TTY: 1-800-325-0778


7 a.m. – 7 p.m.,
Monday – Friday

State Medicaid Offices

Contact information



8 a.m. – 5 p.m.,
Monday – Friday

Best Available Evidence (BAE) policy

If you think you qualify for the Low-Income Subsidy but your current information doesn't reflect that, you can request a review of your status on the Centers for Medicare & Medicaid (CMS) website.

About Best Available Evidence on CMS.gov

MTM: Give your medications a check up

If you qualify, our Medication Therapy Management (MTM) program provides one-on-one consultation with a pharmacist to manage your medications.

Learn more about the MTM Program

Pharmacy documents + coverage levels

Part D coverage levels

To see details for your Part D coverage level, choose your plan below.

2024 Enhanced w/Rx2 ($247.40 combined monthly premium)

Prescription claim forms

Need reimbursement for covered Part D prescription medications and vaccinations not submitted to your Part D coverage? Use the claim instructions and form below to get your prescription processed under your Part D coverage.

Medicare Part D prescription claim form (PDF)

Reimbursement instructions for prescription Part D costs (PDF)

Drug list (formulary)

2024 Formulary (PDF)

Last updated: December 2023