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Prescription Coverage

medicare prescription coverage

CDPHP Medicare Advantage Drug Plans use a formulary, which is a list of covered drugs selected to meet patients' needs. Formularies are reviewed and updated on a regular basis by medical and pharmacy professionals. If the formulary changes, enrollees will be notified before the change takes effect.

Drugs on the formulary are organized into different tiers. What you pay depends on which tier your drugs are in. Please note that generics are frequently the most cost-effective choice.

If you take a drug that is not on our formulary, you may ask us to cover that drug by filling out and submitting the Request for Medicare Prescription Drug Coverage Determination form.

Rx Drugs for less

Rx for Less

With CDPHP Medicare Advantage prescription drug coverage, your dollars go further. Rx for Less offers significant discounts on certain generic drugs at select local pharmacies including CVS, Hannaford, Price Chopper, Market 32, ShopRite, and Walmart. Many generics cost as little as a penny a pill.

Rx by Mail

Mail Order

If you’d rather stay home than head to the pharmacy, you can sign up for automatic mail order delivery of most prescriptions through CVS/Caremark. Most members pay $0 for tier 1 drugs through mail-order.

formulary list icon

Formulary

View a list of covered drugs

insulin

$35 Cost-Share for Insulin

CDPHP has joined the Medicare Senior Savings Program which means that you only pay a $35 cost-share for a 30-day supply of select insulin.

Medicare list of drugs

Drug List

Use our online drug look-up tool

CDPHP Medicare Advantage is an HMO and PPO plan with a Medicare contract. Enrollment in CDPHP Medicare Advantage depends on contract renewal.

Y0019_21_13605 - last updated 10/29/2020