At EmblemHealth, we offer Medicare plans that cover a wide range of prescription drugs. For your convenience, there is a complete list of all covered drugs in our EmblemHealth VIP (HMO) Medicare comprehensive formulary.
This list includes both generic and brand name drugs, and they are listed in levels or “tiers”, based on cost. The lower the level or tier, the lower your cost for the drug will be.
Prior Authorization means that you will need to get approval from your plan before you fill your prescriptions. If you do not get an approval, your plan may not cover the drug. Below is a list of drugs that require prior-authorization.
In general, participants must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations and restrictions may apply. The formulary and pharmacy network may change at any time. You will receive notice when necessary.