Formulary: Which Drugs are Covered?
A Formulary is a list of drugs covered by a plan.
Drugs are added to or removed from our Formulary during the year. If there is a change to coverage for a drug you are taking, the plan will send you a notice to tell you. In most cases we will let you know at least 60 days ahead of time. Check your Summary of Benefits for specific plan benefits and copay/coinsurance information.
Transition Process:
You may learn that drugs you take are not on our 2012 Formulary, or you may learn that your ability to get them is limited. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a Formulary exception so that we will cover the drug you take. For each of your drugs that is not on our Formulary, or if your ability to get your drugs is limited, we will cover a temporary 34-day supply (unless you have a prescription written for fewer days) when you go to a network pharmacy. After your first 34-day supply, we will not pay for these drugs. For additional information on our transition policy, please refer to the plan’s Formulary.
The basic Formulary is designed for someone who does not need broad coverage.
The enhanced Formulary offers broader coverage.
For a complete list of drugs on our Formularies, click on one of the links below.
For your Medicare Part D questions and needs, please let us know how we can assist you.
Contact Us.
Medication Therapy Management Program
We are pleased to offer you the Medication Management Program. This program gives you access to the personal services of a pharmacist who can help look out for your health and safety. In addition, an advisor is available to ensure you get the most value from your benefit plan. The Medication Management Program is offered as part of your prescription drug coverage at no extra cost to you.
This program automatically includes members that meet all of the following criteria:
1. Members with 3 or more of the following chronic conditions: Hypertension, Heart Failure, Diabetes, Dyslipidemia, Respiratory Disease (including asthma, chronic obstructive pulmonary disease, or chronic lung disorders), Bone Disease-Arthritis (such as osteoporosis, osteoarthritis, or rheumatoid arthritis) Mental Health Disorders
2. Taking 8 or more Part D drugs,
3. Likely to incur annual costs for covered Part D drugs that exceed a predetermined level.
If you would like more information on this program, please contact a Medco Medicare Advisor at 1-800-408-6218, between 9:00 a.m. and 6:00 p.m., Eastern Time, Monday through Friday. Customer Service is available in English and other languages. TTY/TDD users should call 1-800-716-3231.
Updated 10/01/11
©1998-2012 First United American Life Insurance Company • All rights reserved • Y0063_12WFUA