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. If you prefer to get certain medications at a retail pharmacy, you can visit any in-network pharmacy and get a 90-day supply for three copays.
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.
- 2022 Formulary - Midwest
- Formulary Updates - Midwest
- Formulary Updates - Reid Health Alliance
- 2022 Formulary - Simplete
- Formulary Updates - Simplete
- 2022 Formulary - Northwest
- 2022 Formulary - Northwest (En Espanol)
- Formulary Updates - Northwest
- Formulary Updates - OSF
Preauthorizations 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
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.
The shingles shot falls under your pharmacy coverage. You can get it at any in-network provider or pharmacy that offers the shot while paying only your Tier 3 cost-share amount.
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.
- Medication Therapy Management
- Sample Patient Medication List and Action Plan
- Specific Drug Requirements
- Medicare Part D Transition Process
High Risk Medications
Find high-risk medications for aging adults and alternative treatments.