This drug search enables you to see if your prescription drug is a covered drug, if your prescription is a generic or brand name drug, and if any special restrictions apply. This drug list is reviewed at least once per month and was last updated on 2/1/2023.
2023 Plan Members:
Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible.
Important Message About What You Pay for Insulin – You won't pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it's on, even if you haven't paid your deductible.
If you would like a comprehensive printable version of the drug list click the "View/Print Drug List" button on the left. A comprehensive formulary is a complete list of covered drugs.
Effective January 1, 2019, we will be changing how we cover opioids and other medications considered to be frequently abused or misused. We have made these changes to comply with CMS requirements and to promote the safe use of medications by our members. Please see FAQ documents for more information on how these changes may affect you and your patients.
To help ensure the safety of our members, PacificSource Medicare enforces the following Drug Utilization Review and Medication Error Identification and Reduction policy.
PacificSource Medicare plans cover both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. Learn more about utilization management which includes prior authorization, quantity limits, and step therapy.
You and your doctor have the right to request an exception to the plan’s formulary or coverage criteria. If your drug is not included in this drug search, you should first contact Customer Service and confirm that your drug is not covered. If you learn that your PacificSource Medicare plan does not cover your drug, you have two options:
The list of covered drugs (formulary) may change at any time. You will receive notice when necessary.