Prescription Drug Benefits


Prescription medication is a blessing 

Medication is sometimes necessary for healthy aging, and we understand how important it is to have reliable drug coverage from your Medicare Advantage plan. Our robust formulary was developed by a team of physicians and pharmacists and covers a wide range of medications.  

Managing your medications can be expensive and confusing. Our Medicare Advantage plans that include Part D drug coverage make the process of getting your prescription drugs both affordable and convenient. Depending on the plan, our enhanced drug coverage generally includes benefits such as $0 copay on Tier 1 preferred generics and no Part D deductible. All of our plans with drug coverage include access to almost 65,000 network pharmacies nationwide.

Our partnership with CVS Caremark allows you to enjoy the benefit of a mail-order pharmacy service. Using a mail-order pharmacy allows you to save money with our mail-order prescription savings opportunities. You will also save time by reducing trips to a pharmacy for medications you take regularly, also known as maintenance drugs. CVS Caremark offers automatic refills, which means they track your refill schedules and ensure you receive your medication on time.   

Concerns over whether a prescribed medication is covered under your plan are put to rest with our real-time formulary and benefit information. This tool allows you to check and compare your prescription drug costs and it can be accessed on the CVS Caremark website. Eligible members will also have access to our Medication Therapy Management (MTM) program, which connects you with a pharmacist for an annual, comprehensive review of your medications and helps you to avoid medication-related problems such as side effects and interactions.

Call to speak with one of our trusted advisors at 1-800-964-4525 (TTY: 711) or to enroll and begin enjoying benefits like this. Receive the benefits of prescription medication without being weighed down by the cost and confusion that often come with it. 

Quality Assurance

We have systems in place to ensure members receive appropriate care that is also safe. Our processes include a review of prescription drug claims in an effort to:

  • Reduce medication errors that may cause adverse reactions.
  • Prevent use of unsafe dosage amounts.
  • Avoid duplicate or unnecessary drugs.

These procedures are beneficial for all members, and in particular, those who have more than one prescribing doctor, use more than one drug, or have more than one pharmacy. 

Making the most of our drug benefits as a member

Call Member Services at 1-800-240-3851 (TTY 711) from 8 a.m. and 8 p.m. 7 days a week.  

Contact your provider and ask if you can switch to 90-day fills for drugs you take every day and send prescriptions to CVS Caremark. By registering on our plan’s member portal website, you will have access to www.caremark.com via our single sign-on functionality.

After enrolling in the automatic refill and renewal programs, CVS Caremark will contact your provider if your prescription expires or is about to run out of refills.

We will cover a temporary supply of your drug during the first 90 days of your membership in the plan. The total supply will be for a maximum of 30 days. If your prescription is written for fewer than 30 days, we will allow multiple fills to provide up to a maximum of a 30-day supply of medication. This period of temporary coverage allows time for you and your prescriber to either switch your drug therapy to a comparable covered alternative or to request a coverage exception for the non-covered drug.

Please refer to your Evidence of Coverage.

MercyOne Health Plan Glory No RX (HMO) does not include drug coverage.

Benefits vary by plans. For more details, please refer to your Evidence of Coverage.

This page was last updated 10/01/2024