Pharmacy Coverage
Plans with pharmacy coverage built in help you keep all your coverage in one place and help you save with special programs and discounts made for you.
Ways to Save
$2 Tier 1 Generics
Get Tier 1 generic drugs for $2 at any in-network pharmacy.
*POS Enrich and our Federal Medicare plan have a $0 copay on Tier 1 generics.
90-Day Supply Options
Limit your trips to the pharmacy with our convenient mail-order benefit. With this benefit you you can get a 90-day supply of your drugs delivered directly to you for two copays on Tiers 1 and 2 or you can get a 90-day supply of drugs on Tiers 3 – 4 for a coinsurance.
If you prefer to get your drugs at a retail pharmacy, you can visit any in-network pharmacy and get a 90-day supply of drugs on Tiers 1 – 2 for three copays or you can get a 90-day supply of drugs on Tiers 3 - 4 for a coinsurance.
Drug Comparison
See how much you’ll pay each month and how much you could save by switching to a pharmacy with lower prescription costs or by taking a lower-cost drug. You can check costs at different pharmacies and see the differences in costs between retail (pickup) or mail order (delivery of a 90-day supply). You can also estimate your total annual drug costs.
Medicare Prescription Payment Plan (M3P)
Starting January 2025, enrollees in Medicare Part D plans (both stand-alone prescription drug plans and Medicare Advantage plans with drug coverage) can choose the new Medicare Prescription Payment Plan (M3P). This program allows you to spread your out-of-pocket Part D drug costs over monthly payments throughout the plan year (January-December) instead of paying at the pharmacy. You can opt in at the start of the plan year or any following month, and can opt out at any time.
Drug Formularies and Updates
Find all the drugs covered by your plan. Use the index at the end to find your drug quickly.
Prior Authorization and Clinical Guidelines
Certain services and drugs require prior authorization, or approval of a drug or medical procedure before the plan will pay for it. Providers should request prior authorization through our online request form.
Members can request their own prior authorization by phone via the number on the back of their member ID card.
More Pharmacy Features
Lowest-Priced Option
If the pharmacy offers a lower price than your copay through us, then you'll only pay that lower price rather than your full copay.
Part D Vaccines
Save money, time and hassle – all while getting the shots you need to help prevent illnesses and stay healthy. If you’re a member of one of our Medicare plans with prescription drug coverage (also called Medicare Part D), you now have a much larger list of vaccines available at no cost to you. The government’s Advisory Committee on Immunization Practices creates a list of their recommended vaccines, and you now can get all Part D vaccines on this list for a $0 copay, without needing to meet your deductible first.
Extra Help Program
You might be able to get help to pay for your prescription drug premiums and costs through the Extra Help program. Use the information below to find out if you qualify.
Patient Assistance Programs
Pharmaceutical manufacturers (companies that make medications) may also have special programs that provide financial help or even certain medications for free. These are called patient assistance programs (PAPs), and they help people with low incomes. Visit this website to learn more, and reach out to your pharmacist and the company that makes your medication for more information.
2025 LIS Premium Rate Sheets
Prescription Drug Safety
Use this program for help taking multiple medications safely and effectively. Find which drugs have special rules or limits to keep you safe and get details on how we’ll help you switch to drugs we cover.
- Medication Therapy Management
- Sample Patient Medication List and Action Plan
- Specific Drug Requirements
- Medicare Part D Transition Process
High Risk Medications
Find high-risk medications for aging adults and alternative treatments.