Get prescription drug information - HMO-POS plans
Cost savings on select insulins
For all Rx plans, you pay $35 for a 1-month supply of eligible insulin products in the Deductible, Initial Coverage and Coverage Gap stages. Click “View Select Insulins” below to see the list of eligible insulin products. NOTE: Insulin administered in an insulin pump is NOT covered under this Part D benefit as it is covered under Medicare Part B.
For more information regarding insulin products, click “View 2022 formulary” above, choose “Antidiabetic Agents” then “Insulins.” Eligible insulins will be designated SI in the Notes & Restrictions column.
For non-covered insulins, such as Humalog, the select insulins list includes similar insulins. If you need help finding an insulin that is similar to the one you are using, please call our Pharmacy Benefit Specialists at 1-877-873-5611 (TTY 711). We are open Monday through Friday, 8 a.m. to 5 p.m.
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.
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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 Ascend Rx* | Monthly Premium for Esteem Rx* |
|---|---|---|---|---|
| 100% | $186.70 | $45.70 | $0.00 | $0 |
| 75% | $197.30 | $56.30 | $10.00 | $0 |
| 50% | $207.90 | $66.90 | $20.00 | $0 |
| 25% | $218.40 | $77.40 | $30.00 | $0 |
* This does not include any Medicare Part B premium you may have to pay. It also does not include the $43 dental premium if you selected the optional comprehensive dental benefit.
Self-help tools
Web access and tools to provide drug pricing transparency, alternative drugs, history of drug claims and side effect information.
Opioid management
Opioids relieve moderate to severe pain but can have side effects and serious risks. Safety measures help reduce opioid use.
Resources
2022
2022 Medicare Advantage HMO-POS Interactive formulary2022 Medicare HMO-POS Comprehensive formulary
2022 Medicare Advantage HMO-POS Prior Authorization formulary
Part D Drug Reimbursement Request form
Part D Vaccine Reimbursement Request form
MedImpact Direct - Medication Mail Order Form
Drug Transition Policy
Drug Safety News
New rules for pain medications
Hospice Information for Medicare Part D Plans