Formulary ID: 24183
Book: 16
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*. Call Member Services for more information.
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*.
*Please refer to your Evidence of Coverage and other plan materials for any deductible that may apply.