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 generic brand prescriptions 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.

 

Medicare Drug List

Drug List


»   Use our online drug look-up tool to review our list of covered drugs (formulary)

PDF iconDownload a PDF of the formulary

Rx 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 ConnectRx, CVS, Hannaford, Price Chopper, Market 32, ShopRite, and Walmart. Many generics cost as little as a penny a pill.

Medicare Rx

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.

Medicare Insulin

$35 Cost Share for Insulin

CDPHP is part of the Medicare Senior Savings Program, which means that you’ll pay no more than $35 for a 30-day supply on all covered insulins.

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

Y_0019_22_16818 – last updated 10/01/2021