Pay BillFormularies and Pharmacies
Prescription drug coverage can play a big role in your decision process when choosing which Medicare Advantage plan will work best for you.
The following information is here to help make it a bit easier for you to compare your options.
Note: If you are using an Apple mobile device (iPhone or iPad) please download the FREE Adobe Acrobat Reader app to ensure you can view our formularies.
View the following formularies to check which drugs are included:
- 2023 Individual Drug Part D Formulary
- 2023 Group Drug Part D Formulary
- 2023 Assure AdvantageSM (C-SNP) Formulary
- 2023 Pharmacy Benefit Dimensions PDP Part D 3 Tier Formulary
- 2023 Pharmacy Benefit Dimensions PDP Part D 5 Tier Formulary
Prior Authorization
Some drugs require you (or your physician) to get prior authorization:
- 2023 Prior Authorization Criteria (Individual/Group)
- 2023 Prior Authorization Criteria (C-SNP)
- 2023 Prior Authorization Criteria (Pharmacy Benefit Dimensions PDP 3 Tier)
- 2023 Prior Authorization Criteria (Pharmacy Benefit Dimensions PDP 5 Tier)
Step Therapy Criteria
In some cases, Independent Health requires that you first try certain drugs to treat your medical condition before we will cover another drug for that condition:
- 2023 Step Therapy Criteria (Individual/Group)
- 2023 Step Therapy Criteria (C-SNP)
- 2023 Step Therapy Criteria for Medicare Part B Drugs
- 2023 Step Therapy Criteria (Pharmacy Benefit Dimensions PDP 3 Tier)
- 2023 Step Therapy Criteria (Pharmacy Benefit Dimensions PDP 5 Tier)
Formulary Quantity Limits
Certain drugs have a quantity limit, which means we’ll provide coverage only up to the limit specified:
Plan Transition Process: If you are new to the plan, we can help you transition when your current drugs are not on the formulary or your ability to get your drugs is limited.
You are covered both locally and nationally with our extensive pharmacy network. For the full list of participating locations, view our pharmacy directory:
We offer mail order pharmacy services through ProAct and Wegmans Mail Order Pharmacy Services. You can use these services to obtain a 90-day supply of maintenance medications.
Learn more about ProAct and Wegmans Mail Order Pharmacy Services and get helpful tips on how to use your mail order pharmacy.
Registration Forms
ProAct Pharmacy Services Registration Form
Wegmans Mail Order Pharmacy Registration Form
Questions? Call Us.
(716) 250-4401 or
1-800-665-1502
(TTY: 711)
Hours:
October 1 – March 31:
Monday – Sunday
8 a.m. – 8 p.m.
April 1 – September 30:
Monday – Friday
8 a.m. – 8 p.m.
Disclaimer
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
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Last Updated 1/3/2023