Part D Prescription Drug Coverage

View the MVP 2023 Medicare Part D formulary (list of covered drugs). (Updated 10/2022)

Most MVP Medicare Advantage plans include Part D prescription drug coverage, making it easy and convenient to manage your prescription needs and expenses.

The MVP Medicare Part D Formulary

Hundreds of generic and brand name medications are covered and listed the Formulary. Learn more about the Formulary and MVP plan prescription coverage.

Covered prescriptions are divided into five tiers, categorized by drug type and cost:

Tier 1 – Preferred Generic Drugs
Tier 2 – Generic Drugs
Tier 3 – Preferred Brand Name Drugs
Tier 4 – Non-Preferred Drugs
Tier 5 – Specialty Drugs

All plans with prescription coverage include $0 Tier 1 Preferred Generic Drugs. You can also save on prescriptions you take regularly using the CVS Caremark Mail Service Pharmacy. Get a three-month supply for the price of two, shipped to your home for free.

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 covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible.

Part D Coverage Details

The Part D benefit is divided into four payment stages. Depending on your plan and prescriptions, you may move from one stage to another during the year.

Deductible Stage

If the MVP Medicare Advantage plan you choose has a deductible, you pay the full cost of drugs in Tiers 3-5 until you reach the deductible.

Initial Coverage Period

You pay your plan’s co-pay or co-insurance for all prescription drugs. All Tier 1 Preferred Generic Drugs are available for a $0 co-pay.

View your cost for a 30-day supply from a retail pharmacy. Costs vary by MVP Medicare plan and region.

Coverage in the Gap

If your total drug costs in 2023 reach $4,660, you enter the Coverage Gap:
With the WellSelect, Patriot, and Secure plans, you pay 25% for generic drugs and 25% for Medicare-contracted brands in the Coverage Gap. With Secure Plus, Preferred Gold, and WellSelect Plus, you pay $0 for Tier 1 drugs, and 25% for generic drugs and 25% for Medicare-contracted brands in Tiers 2-5.

Catastrophic Coverage

If your True Out-of-Pocket costs reach $7,400 in 2023, you reach the Catastrophic Coverage Limit and your cost for prescriptions is reduced to the greater of 5% or $4.15 for generics and $10.35 for brand-name drugs.

Part D Covered Drugs and Pharmacy Directory

View the MVP 2023 Medicare Part D formulary (list of covered drugs). (Updated 10/2022)

Or search drugs on the MVP Medicare Part D Formulary for each plan.

Click here to view the 2023 MVP Medicare Advantage Pharmacy Directory or find a pharmacy near you.

Haga clic aquí para ver el Directorio de farmacias MVP Medicare Advantage 2023 (Updated 11/2022)

Help with Drug Costs

You may be eligible for state or federal programs that lower your monthly prescription drug premium or co-pays

New York State EPIC (Elderly Pharmaceutical Insurance Coverage) 1-800-332-3742
Low Income Subsidy
Call 1-800-Medicare (1-800-633-4227), 24/7, or the Social Security Administration Office at 1-800-772-1213 (TTY 1-800-325-0778)

NOTE: If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare will pay part of your monthly plan premium. MVP will bill you for the amount that Medicare does not cover.

Learn more about MVP’s Medicare Pharmacy Programs.

For certain prescription drugs, MVP has additional requirements or limits on our coverage to ensure that our members use these drugs effectively and to help control drug plan costs. Learn more about our Covered Drugs.

You can ask MVP to cover a drug for a lower cost, remove a coverage requirement or limitation, or cover a drug that is not listed on the Formulary. This is called a coverage determination. Learn more about MVP’s coverage determinations.