Medicare HMO-POS Part D | Security Health Plan

Get prescription drug information - HMO-POS plans

Look up your prescription drugs to find out what tier they are on. Or locate a network pharmacy near you. For Ally Rx D-SNP prescription drug information, click here.

Pharmacy list View 2020 formulary

How are my prescription drugs covered?

Get the most value out of your pharmacy benefit by understanding the formulary for your health insurance plan. A formulary is a list of drugs that are covered by your plan. Look up your prescriptions and learn what tier your drugs are in. The tier tells you how much you will have to pay for your prescription.

What's a formulary?
A formulary is a list of drugs covered by your plan.
What's your formulary used for?
Use the formulary to look up your prescriptions to see what tier they are on, quantity limits, prior authorization requirements or if they are covered by Part B.
What's a drug tier?
A tier tells you how much you will have to pay for your prescriptions.

Other Part D information

Low Income

Subsidy Extra help from Medicare for your drug costs and premiums

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our plan. This table shows you what your monthly plan premium will be if you get extra help.

Your level of extra help	Monthly Premium for Spirit Rx*	Monthly Premium for Essence Rx*	Monthly Premium for Promise Rx*	Monthly Premium for Esteem Rx/Assurance Rx/Surety Rx*
100	$182.10	$40.10	$28.10	$0
75%	$192.10	$50.10	$38.10	$0
50%	$202.00	$60.00	$48.00	$0
25%	$212.00	$70.00	$58.00	$0

*This does not included any Medicare Part B premium you may have to pay. It also does not include the $34 dental premium if you selected the optional supplemental dental benefit.