Prescription Drug Coverage

Amida Care Community Figures 2

Pharmacy Network Directory

Find a pharmacy near you, check to see if your pharmacy is part of our network, or locate a specific type of pharmacy (mail order, long-term care, retail) / Para buscar una farmacia cerca de usted o para comprobar si su farmacia es parte de nuestra red:

English / Spanish

Drug Formulary

We understand it is important to you and your doctors that you get the prescription drugs you need. Amida Care has a list of drugs covered in your plan. This is called a formulary.

List of covered Medicare Part D Drugs (Formulary) – See medications covered by your plan and search for a specific 2016 medication/ Para buscar medicamentos especificos del 2016:

English / Spanish

Prior Authorization

For certain drugs, you or your provider need to get approval from the plan before we will agree to cover the drug for you. This is called “prior authorization.” Below is a link to the prior authorization criteria and the list of medications that require prior authorization.

2016 Prior Authorization Criteria:  English

Step Therapy

This requirement encourages you to try drugs that are less costly but just as effective. This requirement to try a different drug first is called “step therapy.” Below is a link to the list of medications that require step therapy.

2016 Step Therapy Criteria: English

Coverage Determination and Exceptions

An initial coverage decision about your Part D drugs is called a coverage determination. If a drug is not covered in the way you would like it to be covered, you can ask us to make an exception. An exception is a type of coverage decision. More information

Transition Policy and Process

For Part D drugs that are not covered on formulary information on temporary fill.

2016 Transition Policy

Prescription Drug Cost (Co-payments)

2016 English | Spanish