Prescription Coverage
About Prescription Benefits
Health Alliance Medicare Part D Formulary
You can add Part D prescription coverage to any of our Medicare Advantage plans for an additional monthly cost.
The formulary is a list of drugs covered by Health Alliance Medicare. To meet the needs of our members, our formulary is an open formulary, which allows some drugs that are not specifically listed in the formulary to still be covered.
Choose a link to view our formulary or learn how to use it below.
Medicare Part D Abridged Formulary—A partial list of covered drugs. Please read the initial pages of this document for information on how the formulary might be changed during the year.
Medicare Part D Comprehensive Formulary—A complete list of covered drugs. Please read the initial pages of this document for information on how the formulary might be changed during the year.
Both formularies are updated online monthly. View Medicare Part D Formulary Changes for a list of what’s changed since our January 2012 formulary was printed.
How to Use the Formulary
Drugs are listed in alphabetical order. The formulary also lists the Dosage, Dosage Form, Tier, Requirements/Limits and Therapeutic Category.
- Drugs are grouped into these five tiers.
- Tier 1 Preferred Generic
- Tier 2 Non-Preferred Generic
- Tier 3 Preferred Brand
- Tier 4 Non-Preferred Brand
- Tier 5 Specialty
Special Drug Requirements
Certain covered drugs have special requirements or limits on coverage to help make sure your prescriptions are safe and effective.
Step Therapy
This is a process that requires you first to try one drug before your plan will cover another drug. This requirement encourages you to try safer or more effective drugs before we will cover another drug.
View drugs that require step therapy.
Prior Authorization
Prior authorization is approval in advance from your health plan to get certain drugs or medical services.
View drugs that require prior authorization.
Quantity Limits
This is a limit to the amount of a drug Health Alliance Medicare will cover per prescription or for a specific period of time. There may be a limit to how many refills of a certain drug you can get or how much of a certain drug you can get each time you fill a prescription.
