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Pharmacy Coverage

Plans with pharmacy coverage built in help you keep all your coverage in one place and help you save with special programs and discounts made for you. Learn about pharmacy plans and the coverage gap.

Find a Pharmacy Estimate Drug Costs

Ways to Save

$2 Tier 1 Generics

Get Tier 1 generic drugs for $2 at any in-network pharmacy.

90-Day Supply Options

Limit your trips to the pharmacy with two convenient options. With our mail-order benefit, you can get a 90-day supply of certain medications delivered directly to you for two copays on Tiers 1 – 3. If you prefer to get certain medications at a retail pharmacy, you can visit any in-network pharmacy and get a 90-day supply on Tiers 1 – 3 for three copays.

Drug Comparison

See how much you’ll pay each month and how much you could save by switching to a pharmacy with lower prescription costs or by taking a lower-cost drug. You can check costs at different pharmacies and see the differences in costs between retail (pickup) or mail order (delivery of a 90-day supply). You can also estimate your total annual drug costs.

Drug Formularies and Updates

Find all the drugs covered by your plan. Use the index at the end to find your drug quickly.

Prior Authorization and Clinical Guidelines

Certain services and drugs require prior authorization, or approval of a drug or medical procedure before you get it. Providers should request prior authorization through our online request form.

Members can request their own prior authorization by phone via the number on the back of their member ID card.

Receive Over-the-Counter Products Using Your Plan

As a member of Health Alliance Medicare, you can select up to $40 worth of over-the-counter items every quarter and have them shipped to your door for free.

Our Over-the-Counter Catalog includes certain medicines, vitamins, denture care, blood pressure monitors, and much more.

To get started, check out our Over-the-Counter Catalog to find items you may need. When you’re ready, Order Online or call (855) 824-2021 (TTY: 771). You can also use the order form that was mailed to you with the Over-the-Counter Catalog.

More Pharmacy Features

Lowest-Priced Option

If the pharmacy offers a lower price than your copay through us, then you'll only pay that lower price rather than your full copay.

Part D Vaccines

Save money, time and hassle – all while getting the shots you need to help prevent illnesses and stay healthy. If you’re a member of one of our Medicare plans with prescription drug coverage (also called Medicare Part D), you now have a much larger list of vaccines available at no cost to you. The government’s Advisory Committee on Immunization Practices creates a list of their recommended vaccines, and you now can get all Part D vaccines on this list for a $0 copay, without needing to meet your deductible first.

Extra Help Program

You might be able to get help to pay for your prescription drug premiums and costs through the Extra Help program. Use the information below to find out if you qualify.

Patient Assistance Programs

Pharmaceutical manufacturers (companies that make medications) may also have special programs that provide financial help or even certain medications for free. These are called patient assistance programs (PAPs), and they help people with low incomes. Visit this website to learn more, and reach out to your pharmacist and the company that makes your medication for more information.

Prescription Drug Safety

Use this program for help taking multiple medications safely and effectively. Find which drugs have special rules or limits to keep you safe and get details on how we’ll help you switch to drugs we cover.

High Risk Medications

Find high-risk medications for aging adults and alternative treatments.

OptumRx Reimbursement Form for Medicare Part D

Have questions?

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