2020

PLAN
INFORMACIÓN

Express Scripts Medicare Part D Formulary Drugs

Express Scripts Medicare offers reliable coverage for the most commonly prescribed brand and generic medications.

See if your drugs are covered and find out which plan is right for you based on where you live, the drugs you take and the pharmacies you use.

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Medicare Part D Formulary (drug list)

Un vademécum es una lista de medicamentos cubiertos por un plan Part D. Medicare exige que todos los planes Part D cubran al menos dos medicamentos de cada categoría terapéutica. Algunos tipos de medicamentos no están cubiertos por Medicare Parte D, como los medicamentos para perder peso o con fines cosméticos.

Express Scripts Medicare plans typically cover the drugs listed in the formulary, as long as:

  • el medicamento sea necesario por razones médicas;
  • The prescription is filled at one of our network pharmacies
  • Any special drug coverage rules are followed, as required

Algunos tipos de medicamentos no están cubiertos por Medicare Parte D, como los medicamentos para perder peso o con fines cosméticos.

To view and/or print our formulary now, click on the plan option below:

Tenga en cuenta que: Each drug on a formulary is placed on a tier, based on its cost. The lower the tier, the less you pay for the drug:

Tier 1 Preferred Generic Drugs
Tier 2 Generic Drugs
Tier 3 Preferred Brand Drugs
Tier 4 Nonpreferred Drugs
Tier 5 Specialty Drugs

You may also access our online searchable tool to confirm if your drugs are covered and to see if there are any special coverage rules.*

Special drug coverage rules

Some drugs have special coverage rules that may:

  • Limit the amount of a particular drug you can get
  • Require that you get prior approval from the plan before a drug is covered (known as prior authorization)
  • Require that you try a certain drug to treat your condition before another drug is covered (known as step therapy)
  • Limit which pharmacies you can use

Drugs that are subject to these rules are clearly marked in the formulary.

View the list of prescription drugs that currently have prior authorization or step therapy requirements and the rules that apply to each drug:

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Para obtener más información sobre cómo surtir sus recetas, revise la Evidencia de Cobertura.

Once coverage begins, you may request an exception to our coverage rules. Learn more about exceptions and appeals.

Cambios en el vademécum

Express Scripts Medicare plans may periodically:

  • Add or remove a drug from the Drug List
  • Move a drug to a higher or lower cost-sharing tier
  • Add or remove a restriction on coverage for a drug
  • Replace a brand-name drug with a generic drug

If we make certain changes to our formulary for a drug you are taking, we will either notify you at least 30 days before the change is made or notify you after the change is made and give you a 30-day refill of the drug at a network pharmacy.

Nota: If the U.S. Food and Drug Administration finds that a drug on the formulary is unsafe, or if the drug's manufacturer removes the drug from the market under Medicare Part D regulations, we immediately remove the drug from our formulary and then notify you of the change.

For additional information on formulary changes, please review Chapter 3 of the Evidence of Coverage.

¿Necesita ayuda?

Call 1.866.477.5703 TTY users: 1.800.716.3231
8 a.m. to 8 p.m., 7 days a week, except Thanksgiving and Christmas

*If you want a comprehensive formulary mailed to you or if you have questions about covered drugs, please call 1.866.477.5703, 8 a.m. to 8 p.m., 7 days a week, except Thanksgiving and Christmas. TTY users, call 1.800.716.3231. You may also email your request for a formulary to documents@express-scripts.com. Requests sent by email must include: Full name, telephone number and mailing address.

Express Scripts Medicare (PDP) es un plan de medicamentos recetados que tiene un contrato con Medicare.
La inscripción en Express Scripts Medicare depende de la renovación del contrato.

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