Check drug costs
Call us to get information on specific drugs available with your plan.
We're here to help.
Ways to fill your prescription
Prescription support
Extra help paying for your prescription (Low-Income Subsidy)
Find out if you qualify for extra help paying for your prescription drug premiums and costs by contacting any of the organizations below. Click on your state Medicaid office to find contact information.
Medicare |
Contact Information1-800-MEDICARE |
Hours24 hours a day, |
---|---|---|
Social Security Administration |
Contact Information |
Hours7 a.m. – 7 p.m., |
State Medicaid Offices |
Contact Information |
HoursHours vary by state. |
Best available evidence policy
If you think you qualify for the Low-Income Subsidy, but your current information doesn't reflect that, you can request a change to your status on the Centers for Medicare & Medicaid (CMS) website.
About best available evidence on CMS.gov
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.
Pharmacy documents + coverage levels
Part D coverage levels
To see details for your Part D coverage level, choose your plan:
- 2024 Medica Advantage Solution H8889-001 (PPO) ($85 monthly premium)
- 2024 Medica Advantage Solution H8889-002 (PPO) ($95 monthly premium)
- 2024 Medica Advantage Solution H8889-003 (PPO) ($195 monthly premium)
- 2024 Medica Advantage Solution H8889-004 (PPO) ($141 monthly premium)
- 2024 Medica Advantage Solution H8889-005 (PPO) ($0 monthly premium)
- 2024 Medica Advantage Solution H8889-008 (PPO) ($33 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 (Formularies)
Last updated: December 2023