Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community
  • Menu ☰
  • Home
  • Contact
  • MAPD
  • PDP
  • 2020
  • 2021
  • FAQs
  • Articles
  • Search
  • Contact
  • 2020
  • 2021
  • FAQs
  • Articles
  • Latest Medicare News
  • Search


2020 Medicare Part D and Medicare Advantage Plan Formulary Browser

Select your search style and criteria below or use this example to get started

Search by:
State & Plan   ZIP & Plan   PlanID   FormularyID

Search Criteria
PDP     MAPD
Scroll down to see formulary results.

SOLIS SPF 001 (HMO) (H0982-001-0)
Tier 1 (716)
Tier 2 (1780)
Tier 3 (465)
Tier 4 (1475)
Tier 5 (618)
Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either
  *required
 
Cick on the first letter of your drug name to browse the formulary:

A B C D E F G H I J K L 
M N O P Q R S T U V W X Y Z 0-9 
2020 Medicare Part D Plan Formulary Information
SOLIS SPF 001 (HMO) (H0982-001-0)
Benefits & Contact Info           
The SOLIS SPF 001 (HMO) (H0982-001-0)
Formulary Drugs Starting with the Letter D

in Miami-Dade County, FL: CMS MA Region 9 which includes: FL
Plan Monthly Premium: $0.00 Deductible: $0
Drugs Starting with Letter D

Drug Name
Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
D-AMPHETAMINE ER 10 MG CAPSULE   2 Tier 2 $0.00$0.00None
D-AMPHETAMINE ER 15 MG CAPSULE   2 Tier 2 $0.00$0.00None
D-AMPHETAMINE ER 5 MG CAPSULE   2 Tier 2 $0.00$0.00None
D5%-1/2NS-KCL 10 MEQ/L IV SOLUTION   2 Tier 2 $0.00$0.00None
D5%-1/2NS-KCL 30 MEQ/L IV SOLUTION   2 Tier 2 $0.00$0.00None
D5%-1/2NS-KCL 40 MEQ/L IV SOLUTION   2 Tier 2 $0.00$0.00None
DALFAMPRIDINE ER 10 MG TABLET 12H [Ampyra]   1 Tier 1 $0.00$0.00P Q:60
/30Days
DALIRESP 250 MCG TABLET   4 Tier 4 $35.00N/ANone
DALIRESP 500 MCG TABLET   4 Tier 4 $35.00N/ANone
DALVANCE 500 MG VIAL   5 Tier 5 33%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DANAZOL 100 MG CAPSULE [Danocrine]   2 Tier 2 $0.00$0.00None
DANAZOL 50MG CAPSULE   2 Tier 2 $0.00$0.00None
DANAZOL CAPSULES USP 200MG (100 CT)   2 Tier 2 $0.00$0.00None
DANTRIUM 25 MG CAPSULE   4 Tier 4 $35.00N/ANone
DANTRIUM 50 MG CAPSULE   4 Tier 4 $35.00N/ANone
DANTROLENE SODIUM 100MG CAPSULE   2 Tier 2 $0.00$0.00None
DANTROLENE SODIUM 25MG CAPSULE   2 Tier 2 $0.00$0.00None
DANTROLENE SODIUM 50MG CAPSULE   2 Tier 2 $0.00$0.00None
DAPSONE 100 MG TABLET   2 Tier 2 $0.00$0.00None
DAPSONE 25 MG TABLET   2 Tier 2 $0.00$0.00None
DAPTACEL DTAP VACCINE VIAL   3 Tier 3 $0.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DAPTOMYCIN 350 MG VIAL [Cubicin RF]   5 Tier 5 33%N/ANone
DAPTOMYCIN 500 MG VIAL [Cubicin RF]   5 Tier 5 33%N/ANone
DARAPRIM 25 MG TABLET   5 Tier 5 33%N/AQ:90
/30Days
DARIFENACIN ER 15 MG TABLET 24H [Enablex]   2 Tier 2 $0.00$0.00None
DARIFENACIN ER 7.5 MG TABLET 24H [Enablex]   2 Tier 2 $0.00$0.00None
DAURISMO 100 MG TABLET   5 Tier 5 33%N/AP
DAURISMO 25 MG TABLET   5 Tier 5 33%N/AP
DAYPRO 600MG CAPLET   4 Tier 4 $35.00N/ANone
DDAVP 0.01% NASAL SPRAY   4 Tier 4 $35.00N/ANone
DDAVP 0.1 MG TABLET   4 Tier 4 $35.00N/ANone
DDAVP 0.2 MG TABLET   4 Tier 4 $35.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DDAVP 10 MCG/0.1 ML SOLUTION   4 Tier 4 $35.00N/ANone
DEBLITANE 0.35 MG TABLET   2 Tier 2 $0.00$0.00None
DEFERASIROX 125 MG TABLET DISPER [Exjade]   5 Tier 5 33%N/ANone
DEFERASIROX 180 MG TABLET [Jadenu]   5 Tier 5 33%N/ANone
DEFERASIROX 250 MG TABLET DISPER [Exjade]   5 Tier 5 33%N/ANone
DEFERASIROX 360 MG TABLET [Jadenu]   5 Tier 5 33%N/ANone
DEFERASIROX 500 MG TABLET DISPER [Exjade]   5 Tier 5 33%N/ANone
DEFERASIROX 90 MG TABLET [Jadenu]   5 Tier 5 33%N/ANone
DELESTROGEN 40 MG/ML VIAL   4 Tier 4 $35.00N/ANone
DELESTROGEN INJECTION 10MG/5ML VIALMD   4 Tier 4 $35.00N/ANone
DELESTROGEN INJECTION 20MG/5ML VIALMD   4 Tier 4 $35.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DELSTRIGO 100-300-300 MG TABLET   5 Tier 5 33%N/ANone
DEMECLOCYCLINE 150 MG TABLET [Declomycin]   2 Tier 2 $0.00$0.00None
DEMECLOCYCLINE 300 MG TABLET [Declomycin]   2 Tier 2 $0.00$0.00None
DEMSER CAPSULES 250MG (100 CT)   5 Tier 5 33%N/ANone
DENAVIR 1% CREAM (g)   4 Tier 4 $35.00N/ANone
DEPAKOTE 125MG SPRINKLE CAPSULE   4 Tier 4 $35.00N/ANone
DEPAKOTE 125MG TABLET EC   4 Tier 4 $35.00N/ANone
DEPAKOTE DR 250 MG TABLET   4 Tier 4 $35.00N/ANone
DEPAKOTE DR 500 MG TABLET   4 Tier 4 $35.00N/ANone
DEPAKOTE ER 250MG TABLET SA   4 Tier 4 $35.00N/ANone
DEPAKOTE ER 500MG TABLET   4 Tier 4 $35.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEPEN 250MG TITRATAB   3 Tier 3 $0.00N/ANone
DEPO-ESTRADIOL 5MG/ML VIAL   4 Tier 4 $35.00N/ANone
DEPO-PROVERA 150 MG/ML VIAL   4 Tier 4 $35.00N/ANone
DEPO-PROVERA 400MG/ML VIAL   4 Tier 4 $35.00N/ANone
DEPO-TESTOSTERONE 100 MG/ML VIAL   4 Tier 4 $35.00N/ANone
DEPO-TESTOSTERONE 200 MG/ML VIAL   4 Tier 4 $35.00N/ANone
DERMA-SMOOTHE-FS SCALP OIL   3 Tier 3 $0.00N/ANone
DESCOVY 200-25 MG TABLET   5 Tier 5 33%N/ANone
DESIPRAMINE 10 MG TABLET [Norpramin]   2 Tier 2 $0.00$0.00P
DESIPRAMINE 100 MG TABLET [Norpramin]   2 Tier 2 $0.00$0.00P
DESIPRAMINE 150 MG TABLET [Norpramin]   2 Tier 2 $0.00$0.00P
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DESIPRAMINE 25 MG TABLET [Norpramin]   2 Tier 2 $0.00$0.00P
DESIPRAMINE 50 MG TABLET [Norpramin]   2 Tier 2 $0.00$0.00P
DESIPRAMINE 75 MG TABLET [Norpramin]   2 Tier 2 $0.00$0.00P
DESLORATADINE 5 MG TABLET   2 Tier 2 $0.00$0.00None
DESMOPRESSIN ACETATE 0.1 MG TABLET   2 Tier 2 $0.00$0.00None
DESMOPRESSIN ACETATE 0.2 MG TABLET   2 Tier 2 $0.00$0.00None
DESMOPRESSIN ACETATE NASAL SOLUTION 0.1% 5 ML BOTSPR   2 Tier 2 $0.00$0.00None
DESOGEST-ETH ESTRA 0.15-0.03MG TABLET [Solia]   2 Tier 2 $0.00$0.00None
DESOGESTR-ETH ESTRAD ETH ESTRA TABLET [Volnea]   2 Tier 2 $0.00$0.00None
DESONATE 0.05% GEL   4 Tier 4 $35.00N/AP
Desonide 0.0005 MG/MG Topical Ointment   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DESONIDE 0.05% CREAM (g) [Tridesilon]   2 Tier 2 $0.00$0.00P
DESONIDE 0.05% LOTION [LoKara]   2 Tier 2 $0.00$0.00P
DesOwen 0.5mg/g 60 g in 1 TUBE   4 Tier 4 $35.00N/AP
Desoximetasone 0.0005 MG/MG Topical Ointment   2 Tier 2 $0.00$0.00None
DESOXIMETASONE 0.25% CREAM   2 Tier 2 $0.00$0.00None
DESOXIMETASONE 0.25% OINTMENT [Topicort]   2 Tier 2 $0.00$0.00None
Desoximetasone 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE   2 Tier 2 $0.00$0.00None
Desoximetasone 0.5mg/g 1 TUBE per CARTON / 60 g in 1 TUBE   2 Tier 2 $0.00$0.00None
DESVENLAFAXINE SUC ER 100 MG TABLET ER 24H [Pristiq]   2 Tier 2 $0.00$0.00None
DESVENLAFAXINE SUC ER 25 MG TABLET ER 24H [Pristiq]   2 Tier 2 $0.00$0.00None
Desvenlafaxine Succinate ER 50 mg tablet [Pristiq]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DETROL 1 MG TABLET   4 Tier 4 $35.00N/ANone
DETROL 2 MG TABLET   4 Tier 4 $35.00N/ANone
DETROL LA 2 MG CAPSULE   4 Tier 4 $35.00N/ANone
DETROL LA 4 MG CAPSULE   4 Tier 4 $35.00N/ANone
DEXAMETHASONE 0.1% EYE DROP   2 Tier 2 $0.00$0.00None
DEXAMETHASONE 0.5MG TABLET   1 Tier 1 $0.00$0.00None
DEXAMETHASONE 0.5MG/0.5ML EYE DROP   2 Tier 2 $0.00$0.00None
DEXAMETHASONE 0.5MG/5ML ELX   2 Tier 2 $0.00$0.00None
DEXAMETHASONE 0.75MG TABLET   1 Tier 1 $0.00$0.00None
DEXAMETHASONE 1.5MG TABLET   1 Tier 1 $0.00$0.00None
DEXAMETHASONE 1MG TABLET   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEXAMETHASONE 2MG TABLET   2 Tier 2 $0.00$0.00None
DEXAMETHASONE 4MG TABLET   1 Tier 1 $0.00$0.00None
DEXAMETHASONE 6MG TABLET   1 Tier 1 $0.00$0.00None
DEXEDRINE SPANSULE 10 MG CAPSULE ER   4 Tier 4 $35.00N/ANone
DEXEDRINE SPANSULE 15 MG CAPSULE ER   4 Tier 4 $35.00N/ANone
DEXEDRINE SPANSULE 5 MG CAPSULE ER   4 Tier 4 $35.00N/ANone
DEXMETHYLPHENIDATE 10 MG TABLET [Focalin]   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE 2.5 MG TABLET [Focalin]   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE 5 MG TABLET [Focalin]   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 10 MG CAPSULE   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 15 MG CAPSULE CPBP 50-50 [Focalin XR]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEXMETHYLPHENIDATE ER 20 MG CAPSULE CPBP 50-50 [Focalin XR]   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 25 MG CAPSULE CPBP 50-50 [Focalin XR]   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 30 MG CAPSULE CPBP 50-50 [Focalin XR]   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 35 MG CAPSULE   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 40 MG CAPSULE   2 Tier 2 $0.00$0.00None
DEXMETHYLPHENIDATE ER 5 MG CAPSULE CPBP 50-50 [Focalin XR]   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHET ER 10 MG CAPSULE ER 24H [Adderall XR]   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHET ER 15 MG CAPSULE ER 24H [Adderall XR]   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHET ER 20 MG CAPSULE ER 24H [Adderall XR]   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHET ER 25 MG CAPSULE ER 24H [Mydayis]   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHET ER 30 MG CAPSULE ER 24H [Adderall XR]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEXTROAMP-AMPHET ER 5 MG CAPSULE ER 24H [Adderall XR]   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHETAMIN 20 MG TABLET   2 Tier 2 $0.00$0.00None
DEXTROAMP-AMPHETAMIN 30 MG TABLET   2 Tier 2 $0.00$0.00None
DEXTROAMPHETAMINE 10 MG TABLET [Zenzedi]   2 Tier 2 $0.00$0.00None
DEXTROAMPHETAMINE 5 MG TABLET [Zenzedi]   2 Tier 2 $0.00$0.00None
DEXTROAMPHETAMINE 5 MG/5 ML SOLUTION [ProCentra]   2 Tier 2 $0.00$0.00None
DEXTROAMPHETAMINE SACCHARATE AND SULFATE AMPHETAMINE ASPARTATE 10MG TABLET (100 CT)   2 Tier 2 $0.00$0.00None
DEXTROSE 10%-1/4NS IV TUBEX   3 Tier 3 $0.00N/AP
DEXTROSE 10%-WATER IV SOLUTION DEHP FR BG   2 Tier 2 $0.00$0.00P
DEXTROSE 2.5%-1/2NS IV SOLUTION   2 Tier 2 $0.00$0.00None
DEXTROSE 5%-0.2% NACL IV SOLUTION   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DEXTROSE 5%-0.45% NACL IV SOLUTION   2 Tier 2 $0.00$0.00None
DEXTROSE 5%-0.9% NACL IV SOLUTION   2 Tier 2 $0.00$0.00None
DEXTROSE 5%-1/4NS IV SOLUTION   2 Tier 2 $0.00$0.00None
DEXTROSE 5%-WATER IV SOLUTION   2 Tier 2 $0.00$0.00None
DEXTROSE IN SODIUM CHLORIDE INJECTION   3 Tier 3 $0.00N/AP
DIASTAT 2.5 MG PEDI SYSTEM   3 Tier 3 $0.00N/ANone
DIASTAT ACUDIAL 12.5-15-20 MG   3 Tier 3 $0.00N/ANone
DIASTAT ACUDIAL 5-7.5-10 MG KIT   3 Tier 3 $0.00N/ANone
DIAZEPAM 10 MG RECTAL GEL SYST KIT [Diastat]   3 Tier 3 $0.00N/ANone
DIAZEPAM 10 MG TABLET [Valium]   1 Tier 1 $0.00$0.00None
DIAZEPAM 2 MG TABLET [Valium]   1 Tier 1 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DIAZEPAM 2.5 MG RECTAL GEL SYST KIT [Diastat]   3 Tier 3 $0.00N/ANone
DIAZEPAM 20 MG RECTAL GEL SYST KIT [Diastat]   3 Tier 3 $0.00N/ANone
DIAZEPAM 5 MG ORAL TABLET [Valium]   4 Tier 4 $35.00N/ANone
DIAZEPAM 5 MG TABLET [Valium]   1 Tier 1 $0.00$0.00None
DIAZEPAM 5 MG/5 ML SOLUTION   2 Tier 2 $0.00$0.00None
DIAZEPAM 5 MG/ML ORAL CONC   2 Tier 2 $0.00$0.00None
DIAZOXIDE 50 MG/ML ORAL SUSPENSION [Proglycem]   2 Tier 2 $0.00$0.00None
DIBENZYLINE 10 MG CAPSULE   4 Tier 4 $35.00N/ANone
DICLOFENAC 0.1% EYE DROPS [Voltaren]   1 Tier 1 $0.00$0.00None
DICLOFENAC EPOLAMINE 1.3% PATCH TD12 [Licart]   4 Tier 4 $35.00N/AP Q:60
/30Days
DICLOFENAC POT 50 MG TABLET [Cataflam]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DICLOFENAC SOD EC 25 MG TABLET   2 Tier 2 $0.00$0.00None
DICLOFENAC SOD EC 50 MG TABLET   2 Tier 2 $0.00$0.00None
DICLOFENAC SOD EC 75 MG TABLET   2 Tier 2 $0.00$0.00None
DICLOFENAC SOD ER 100 MG TABLET ER 24H [Voltaren-XR]   2 Tier 2 $0.00$0.00None
Diclofenac sodium 1.5% soln   2 Tier 2 $0.00$0.00Q:450
/30Days
Diclofenac Sodium 1% gel   2 Tier 2 $0.00$0.00Q:1000
/30Days
Diclofenac Sodium 3% gel   2 Tier 2 $0.00$0.00P Q:300
/30Days
DICLOFENAC-MISOPROST 50-200 TABLET IR DR [Arthrotec]   2 Tier 2 $0.00$0.00None
DICLOFENAC-MISOPROST 75-200 TABLET IR DR [Arthrotec]   2 Tier 2 $0.00$0.00None
DICLOXACILLIN 250MG CAPSULE   2 Tier 2 $0.00$0.00None
DICLOXACILLIN SODIUM 500MG CAPSULE   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DICYCLOMINE 10 MG CAPSULE [Bentyl]   1 Tier 1 $0.00$0.00None
DICYCLOMINE 20 MG TABLET [Bentyl]   1 Tier 1 $0.00$0.00None
DICYCLOMINE HCL 10MG/5ML SYRUP   2 Tier 2 $0.00$0.00None
DIDANOSINE DR 250 MG CAPSULE [Videx EC]   2 Tier 2 $0.00$0.00None
DIDANOSINE DR 400 MG CAPSULE [Videx EC]   2 Tier 2 $0.00$0.00None
DIFFERIN 0.1% CREAM   4 Tier 4 $35.00N/AP
DIFFERIN 0.3% GEL PUMP   4 Tier 4 $35.00N/AP
DIFFERIN LOTION   4 Tier 4 $35.00N/AP
Dificid 200mg/1 1 BOTTLE per CARTON / 20 FILM COATED TABLETS in BOTTLE   5 Tier 5 33%N/AS Q:20
/10Days
DIFLUCAN 100MG TABLET   4 Tier 4 $35.00N/ANone
DIFLUCAN 150MG TABLET   4 Tier 4 $35.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DIFLUCAN 200MG TABLET   4 Tier 4 $35.00N/ANone
DIFLUCAN 200MG/5ML SUSPEN   4 Tier 4 $35.00N/ANone
DIFLUCAN 50MG TABLET   4 Tier 4 $35.00N/ANone
DIFLUCAN 50MG/5ML SUSPEN   4 Tier 4 $35.00N/ANone
DIFLUNISAL 500 MG TABLET [Dolobid]   2 Tier 2 $0.00$0.00None
DIGITEK 125 MCG TABLET   2 Tier 2 $0.00$0.00None
DIGITEK 250 MCG TABLET   2 Tier 2 $0.00$0.00None
DIGOX 125 MCG TABLET   2 Tier 2 $0.00$0.00None
DIGOX 250 MCG TABLET   2 Tier 2 $0.00$0.00None
DIGOXIN 0.05 MG/ML SOLUTION [Lanoxin]   2 Tier 2 $0.00$0.00None
DIGOXIN 0.25 MG TABLET [Lanoxin]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DIGOXIN 125 MCG TABLET [Lanoxin]   2 Tier 2 $0.00$0.00None
DIHYDROERGOTAMINE 4 MG/ML SPRAY   4 Tier 4 $35.00N/AQ:16
/30Days
DILANTIN 50MG INFATAB   4 Tier 4 $35.00N/ANone
DILANTIN CAPSULES 30 MG ER   3 Tier 3 $0.00N/ANone
DILANTIN EXTENDED ORAL CAPSULE 100MG (100 CT)   4 Tier 4 $35.00N/ANone
DILANTIN-125 SUS 125/5ML   4 Tier 4 $35.00N/ANone
DILAUDID 2 MG TABLET   4 Tier 4 $35.00N/AQ:450
/30Days
DILAUDID 4 MG TABLET   4 Tier 4 $35.00N/AQ:240
/30Days
DILAUDID 5 MG/5 ML ORAL LIQUID   4 Tier 4 $35.00N/AQ:2400
/30Days
DILAUDID 8 MG TABLET   4 Tier 4 $35.00N/AQ:120
/30Days
DILT XR 120 MG CAPSULE   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DILT XR 180 MG CAPSULE   2 Tier 2 $0.00$0.00None
DILT XR 240 MG CAPSULE   2 Tier 2 $0.00$0.00None
DILTIAZEM 120 MG TABLET [Cardizem]   1 Tier 1 $0.00$0.00None
DILTIAZEM 12HR ER 120 MG CAPSULE [Tiazac]   2 Tier 2 $0.00$0.00None
DILTIAZEM 12HR ER 60 MG CAPSULE [Cardizem SR]   2 Tier 2 $0.00$0.00None
DILTIAZEM 12HR ER 90 MG CAPSULE [Cardizem SR]   2 Tier 2 $0.00$0.00None
DILTIAZEM 24HR ER 120 MG CAPSULE [Tiazac]   2 Tier 2 $0.00$0.00None
DILTIAZEM 24HR ER 180 MG CAPSULE [Tiazac]   2 Tier 2 $0.00$0.00None
DILTIAZEM 24HR ER 240 MG CAPSULE [Tiazac]   2 Tier 2 $0.00$0.00None
DILTIAZEM 24HR ER 300 MG CAPSULE [Tiazac]   2 Tier 2 $0.00$0.00None
DILTIAZEM 24HR ER 360 MG CAPSULE SA 24H [Tiazac]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DILTIAZEM 24HR ER 420 MG CAPSULE [Tiazac]   2 Tier 2 $0.00$0.00None
DILTIAZEM 30 MG TABLET [Cardizem]   1 Tier 1 $0.00$0.00None
DILTIAZEM 60 MG TABLET [Cardizem]   1 Tier 1 $0.00$0.00None
DILTIAZEM 90 MG TABLET [Cardizem]   1 Tier 1 $0.00$0.00None
DIOVAN 160MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN 320MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN 40MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN 80MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN HCT 160/12.5MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN HCT 160/25MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN HCT 320/12.5MG TABLET   4 Tier 4 $35.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DIOVAN HCT 320/25MG TABLET   4 Tier 4 $35.00N/ANone
DIOVAN HCT 80/12.5MG TABLET   4 Tier 4 $35.00N/ANone
DIPENTUM 250 MG CAPSULE   4 Tier 4 $35.00N/ANone
Diph-Tetanus Tox-Acell Pert adsorbed and IPV vaccine 0.5 ML Prefilled Syringe [Kinrix]   3 Tier 3 $0.00N/ANone
Diph-Tetanus Tox-Acell Pert-Hepatitis B-Polio IPV Vac 0.5 ML Prefilled Syringe [Pediarix]   3 Tier 3 $0.00N/ANone
Diphenoxylate Hydrochloride and Atropine Sulfate 0.025; 2.5mg 100 TABLET BOTTLE   2 Tier 2 $0.00$0.00None
DIPHENOXYLATE/ATROPINE LIQ   2 Tier 2 $0.00$0.00None
Diphtheria Toxoid Vaccine 25 UNT/ML / Tetanus Toxoid Vaccine 5 UNT per 0.5 ML Injectable Suspension   3 Tier 3 $0.00N/AP
DIPROLENE 0.05% OINTMENT   4 Tier 4 $35.00N/ANone
DISOPYRAMIDE 100 MG CAPSULE   2 Tier 2 $0.00$0.00P
DISOPYRAMIDE PHOSPHATE 150MG CAPSULE USP (100 CT)   2 Tier 2 $0.00$0.00P
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DISULFIRAM 250 MG TABLET   2 Tier 2 $0.00$0.00None
DISULFIRAM 500 MG TABLET   2 Tier 2 $0.00$0.00None
DITROPAN XL 10 MG TABLET   4 Tier 4 $35.00N/ANone
DITROPAN XL 5 MG TABLET   4 Tier 4 $35.00N/ANone
DIURIL 250MG/5ML SUSPENSION ORAL   3 Tier 3 $0.00N/ANone
DIVALPROEX DR 125 MG CAPSULE SPRNK   2 Tier 2 $0.00$0.00None
DIVALPROEX SOD DR 125 MG TABLET   1 Tier 1 $0.00$0.00None
DIVALPROEX SOD DR 250 MG TABLET   1 Tier 1 $0.00$0.00None
DIVALPROEX SOD DR 500 MG TABLET   1 Tier 1 $0.00$0.00None
DIVALPROEX SOD ER 250 MG TABLET ER 24H [Depakote ER]   2 Tier 2 $0.00$0.00None
DIVALPROEX SOD ER 500 MG TABLET ER 24H [Depakote ER]   2 Tier 2 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DOFETILIDE 125 MCG CAPSULE [Tikosyn]   2 Tier 2 $0.00$0.00None
DOFETILIDE 250 MCG CAPSULE [Tikosyn]   2 Tier 2 $0.00$0.00None
DOFETILIDE 500 MCG CAPSULE [Tikosyn]   2 Tier 2 $0.00$0.00None
DOLOPHINE HCL 10MG TABLET   4 Tier 4 $35.00N/AQ:360
/30Days
DOLOPHINE HYDROCHLORIDE 5mg 100 TABLET BOTTLE   4 Tier 4 $35.00N/AQ:360
/30Days
DONEPEZIL HCL 10 MG TABLET   1 Tier 1 $0.00$0.00None
DONEPEZIL HCL 23 MG TABLET [Aricept]   2 Tier 2 $0.00$0.00Q:30
/30Days
DONEPEZIL HCL 5 MG TABLET   1 Tier 1 $0.00$0.00None
DONEPEZIL HCL ODT 10 MG TABLET   2 Tier 2 $0.00$0.00Q:30
/30Days
DONEPEZIL HCL ODT 5 MG TABLET   2 Tier 2 $0.00$0.00Q:30
/30Days
DOPTELET 20 MG (30 TABLET PK)   5 Tier 5 33%N/AP Q:60
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DOPTELET 20 MG TABLET   5 Tier 5 33%N/AP Q:10
/5Days
DOPTELET 20 MG TABLET   5 Tier 5 33%N/AP Q:15
/5Days
DORZOLAMIDE HCL 2% EYE DROPS [Trusopt]   1 Tier 1 $0.00$0.00None
Dorzolamide Hydrochloride and Timolol Maleate 20; 5mg/mL; mg/mL 1 BOTTLE, DROPPER in 1 BOX / 10 mL   1 Tier 1 $0.00$0.00None
DORZOLAMIDE-TIMOLOL 2%-0.5% DROPERETTE [Cosopt PF]   2 Tier 2 $0.00$0.00None
DOTTI 0.025 MG PATCH TDSW [Vivelle-Dot]   2 Tier 2 $0.00$0.00None
DOTTI 0.0375 MG PATCH TDSW [Vivelle-Dot]   2 Tier 2 $0.00$0.00None
DOTTI 0.05 MG PATCH TDSW [Vivelle-Dot]   2 Tier 2 $0.00$0.00None
DOTTI 0.075 MG PATCH TDSW [Vivelle-Dot]   2 Tier 2 $0.00$0.00None
DOTTI 0.1 MG PATCH TDSW [Vivelle-Dot]   2 Tier 2 $0.00$0.00None
DOVATO 50-300 MG TABLET   5 Tier 5 33%N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DOVONEX CREAM   4 Tier 4 $35.00N/AQ:240
/30Days
DOXAZOSIN MESYLATE 1 MG TABLET [Cardura]   1 Tier 1 $0.00$0.00None
DOXAZOSIN MESYLATE 2 MG TABLET [Cardura]   1 Tier 1 $0.00$0.00None
DOXAZOSIN MESYLATE 4 MG TABLET [Cardura]   1 Tier 1 $0.00$0.00None
DOXAZOSIN MESYLATE 8 MG TABLET [Cardura]   1 Tier 1 $0.00$0.00None
DOXEPIN 10 MG/ML ORAL CONC   2 Tier 2 $0.00$0.00P
DOXEPIN 10MG CAPSULE   2 Tier 2 $0.00$0.00P
DOXEPIN 50 MG CAPSULE   2 Tier 2 $0.00$0.00P
DOXEPIN 75MG CAPSULE   2 Tier 2 $0.00$0.00P
DOXEPIN HCL 25MG CAPSULE (100 CT)   2 Tier 2 $0.00$0.00P
Doxepin Hydrochloride 150mg/1 100 CAPSULE BOTTLE   2 Tier 2 $0.00$0.00P
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DOXEPIN HYDROCHLORIDE CAPSULES 100MG 100 BOT   2 Tier 2 $0.00$0.00P
Doxercalciferol 0.5 mcg capsule [HECTOROL]   2 Tier 2 $0.00$0.00P
Doxercalciferol 1 mcg capsule [HECTOROL]   2 Tier 2 $0.00$0.00P
Doxercalciferol 2.5 mcg capsule [HECTOROL]   2 Tier 2 $0.00$0.00P
DOXY 100 VIAL   2 Tier 2 $0.00$0.00None
doxycycline 25 mg/5 ml susp   2 Tier 2 $0.00$0.00None
DOXYCYCLINE HYCLATE 100 MG CAPSULE   1 Tier 1 $0.00$0.00None
DOXYCYCLINE HYCLATE 100 MG TABLET [Vibra-Tabs]   1 Tier 1 $0.00$0.00None
DOXYCYCLINE HYCLATE 20MG TABLET (100 CT)   1 Tier 1 $0.00$0.00None
DOXYCYCLINE HYCLATE 50 MG CAPSULE   1 Tier 1 $0.00$0.00None
DOXYCYCLINE MONO 100 MG CAPSULE   1 Tier 1 $0.00$0.00None
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DOXYCYCLINE MONO 100 MG TABLET   1 Tier 1 $0.00$0.00None
DOXYCYCLINE MONO 50 MG CAPSULE [Monodox]   1 Tier 1 $0.00$0.00None
DOXYCYCLINE MONO 50 MG TABLET   1 Tier 1 $0.00$0.00None
DOXYCYCLINE MONO 75 MG TABLET   1 Tier 1 $0.00$0.00None
DRIZALMA SPRINKLE DR 20 MG CAPSULE   4 Tier 4 $35.00N/AS
DRIZALMA SPRINKLE DR 30 MG CAPSULE   4 Tier 4 $35.00N/AS
DRIZALMA SPRINKLE DR 40 MG CAPSULE   4 Tier 4 $35.00N/AS
DRIZALMA SPRINKLE DR 60 MG CAPSULE   4 Tier 4 $35.00N/AS
DRONABINOL 10 MG CAPSULE [Marinol]   2 Tier 2 $0.00$0.00P
DRONABINOL 2.5 MG CAPSULE [Marinol]   2 Tier 2 $0.00$0.00P
DRONABINOL 5 MG CAPSULE [Marinol]   2 Tier 2 $0.00$0.00P
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DROSPIRENONE-EE 3-0.02 MG TABLET   2 Tier 2 $0.00$0.00None
DROSPIRENONE-EE 3-0.03 MG TABLET   2 Tier 2 $0.00$0.00None
DROXIA 200MG CAPSULE   3 Tier 3 $0.00N/ANone
DROXIA 300MG CAPSULE   3 Tier 3 $0.00N/ANone
DROXIA 400MG CAPSULE   3 Tier 3 $0.00N/ANone
DULERA 50 MCG-5 MCG INHALER HFA AEROSOL AD   3 Tier 3 $0.00N/AQ:13
/30Days
DULERA INHALATION AEROSOL   3 Tier 3 $0.00N/AQ:13
/30Days
DULERA INHALATION AEROSOL   3 Tier 3 $0.00N/AQ:13
/30Days
DULOXETINE HCL DR 20 MG CAPSULE [Cymbalta]   1 Tier 1 $0.00$0.00None
DULOXETINE HCL DR 30 MG CAPSULE [Cymbalta]   1 Tier 1 $0.00$0.00None
DULOXETINE HCL DR 40 MG CAPSULE [Irenka]   2 Tier 2 $0.00$0.00S Q:30
/30Days
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DULOXETINE HCL DR 60 MG CAPSULE [Cymbalta]   1 Tier 1 $0.00$0.00None
DUPIXENT 200 MG/1.14 ML SYRINGE   5 Tier 5 33%N/AP
DUPIXENT 300 MG/2 ML SAFE SYRINGE   5 Tier 5 33%N/AP
DURAGESIC 100 MCG/HR PATCH TD72   4 Tier 4 $35.00N/AQ:10
/30Days
DURAGESIC 12 MCG/HR PATCH TD72   4 Tier 4 $35.00N/AQ:10
/30Days
DURAGESIC 25 MCG/HR PATCH TD72   4 Tier 4 $35.00N/AQ:10
/30Days
DURAGESIC 50 MCG/HR PATCH TD72   4 Tier 4 $35.00N/AQ:10
/30Days
DURAGESIC 75 MCG/HR PATCH TD72   4 Tier 4 $35.00N/AQ:10
/30Days
duramorph 0.5 mg/ml ampule   2 Tier 2 $0.00$0.00P
duramorph 1 mg/ml ampule   2 Tier 2 $0.00$0.00P
DUREZOL 0.05% EYE DROPS   3 Tier 3 $0.00N/ANone
Drug Name Tier
Nbr.
Tier
Description
30-Day
Preferred
Pharm
90-Day
Mail
Order
Drug
Usage
Mgmt
DUTASTERIDE 0.5 MG CAPSULE [Avodart]   1 Tier 1 $0.00$0.00None
DUTASTERIDE-TAMSULOSIN 0.5-0.4 CPMP 24HR [Jalyn]   2 Tier 2 $0.00$0.00None
DYAZIDE 37.5-25 CAPSULE   4 Tier 4 $35.00N/ANone
DYRENIUM 100 MG CAPSULE   3 Tier 3 $0.00N/ANone
DYRENIUM 50 MG CAPSULE   3 Tier 3 $0.00N/ANone

Chart Legend:

Below are a few notes to help you understand the above 2020 Medicare Part D SOLIS SPF 001 (HMO) Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug or Medicare Advantage plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region). The plan name is followed by the plan type (PDP, HMO, HMO-POS, PPO, PFFS, etc.)

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the standard $435 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.
    • No - This plan does not qualify for the $0 Premium for persons with the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.

  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have five (5) tiers 1=Preferred Generics, 2=Generics, 3=Preferred Brands, 4=Non-preferred Brands, 5=Specialty Drugs.
    • Tier Number* - Some Part D drug plans exclude one or more drug tiers from the plan’s deductible. If the drug tier field above is followed by * (example: 2*), then this drug tier is excluded from the plan’s deductible.
    • Tier Description - This is the Medicare Part D plan’s description of this particular drug tier.

  • Cost Sharing - Copay / Coinsurance - This is what you will pay for formulary drugs in the Initial Coverage Phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the initial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $4020) at a "Preferred" network pharmacy. In most cases, the "Preferred" network pharmacy cost-sharing is lower than the standard (non-preferred) network pharmacy cost-sharing.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).

  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.


(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2020 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Medicare plan provider.








Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.