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Pharmacies and Prescriptions

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Medica ChoiceCare MSC+

Pharmacy Benefits

Your plan includes pharmacy benefits that cover certain:

  • Drugs covered by Medical Assistance
  • Over-the-Counter drugs
  • Medication Therapy Management services (if you do not have Medicare Part D benefits)

List of covered drugs (PDF)

How To Fill A Prescription

To get a prescription filled:

  1. Check the List of Covered Drugs to see if your drug is covered.
  2. Have your doctor write the prescription.
  3. Get your prescription filled at a pharmacy in the Medica network.

Copay Information

The most you will have to pay in prescription copays is $12 per month. Some mental health drugs and most family planning drugs do not have a copay.

Type of Drug  Copay Amount
Brand-name drugs $3
Generic drugs  $1


Covered Drugs

To find out if a drug is covered, select from the lists below. For drug limitations and exceptions, refer to your Member Handbook.

List of Covered Drugs

The following is the comprehensive List of Covered Drugs (Formulary) that includes drugs covered by Medical Assistance and Over-the-Counter drugs. To receive a covered drug, you need to have your health care provider write a prescription for it and then you can take the prescription to a pharmacy in the Medica network. The pharmacist will give you a generic version of the drug if one is available.

2020 List of Covered Drugs (Formulary) – (PDF)



Specialty Drugs

Specialty drugs are used to treat certain complicated health problems. These drugs tend to be very expensive and may need special handling and monitoring. For most specialty medications, you'll use Accredo Specialty Pharmacy, our preferred Specialty Drug Program vendor as of 1/1/2018, to fill your prescriptions. There are a small number of drugs not available through Accredo Specialty Pharmacy. Discuss your options about these limited distribution drugs with your prescriber.

View the 2019 specialty drug list (PDF)

2020 Minnesota Health Care Programs Specialty Drug List (PDF)

If you need to fill a new specialty drug:

  1. Check the specialty drug list, which shows all of the medications Medica considers specialty drugs.
  2. Your plan may not cover all of the drugs on the specialty drug list. If you have questions about your coverage for a specialty drug, please call customer service at the number on the back of your Medica ID card.
  3. Once you've verified your coverage, have your prescription filled through Accredo Specialty Pharmacy*.

Note: If you fill your specialty drug prescription through a vendor other than Accredo Specialty Pharmacy*, your drug will not be covered and you will be responsible for the entire cost.

How to refill your prescription with Accredo Specialty Pharmacy:

After your first fill, you can create an account on Accredo’s Patient Portal to view and manage your refills. You will need an active Accredo prescription number to register on the portal. You can access the portal by visiting medica.com/AccredoSpecialtyRx. You can also request a refill by calling the number below.

Accredo Specialty Pharmacy

Phone: 1-866-544-6817 (toll-free) (TTY users dial 711)
Accredo Customer Service representatives will be available Monday through Friday 7 a.m. – 10 p.m. and Saturday 7 a.m. – 4 p.m. Central.

*Or through the designated specialty pharmacy vendor if it's a limited distribution drug.

 

Last updated: March 2019


Diabetic Meters

Medica's Drug List includes Accu-Chek® blood glucose meters and testing supplies.

Step 1: Download, complete and submit this CVS form (PDF)

Step 2: CVS will contact your doctor for the test strips and lancets; your no-cost meter will be shipped separately.


Find a Pharmacy

Use our directory to find a network pharmacy near you.

Pharmacy directory (PDF) 

Review Your Medications

Talk to a pharmacist and learn how to get the safest and most effective results from your drugs with Medication Therapy Management (MTM). 

Learn about MTM

Do You Have a Medicare Plan?

If you have Medicare, you must get most of your prescription drugs through the Medicare Prescription Drug Program (Medicare Part D). Your Part D plan will pay for most of your prescription drugs. You may have a copay.



American Indians can continue to use tribal and Indian Health Services (IHS) clinics. We will not require prior approval or impose any conditions for you to get services at these clinics. For elders age 65 years and older this includes Elderly Waiver (EW) services accessed through the tribe. If a doctor or other provider in a tribal or IHS clinic refers you to a provider in our network, we will not require you to see your primary care provider prior to the referral.


 

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