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Formulary ID: 26329

Book: 9

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*.

Starting July 1st, 2026, you may be eligible to access certain GLP-1 medications (Foundayo® tablets, Wegovy® oral and injectable, and Zepbound KwikPen®) for weight loss through the Medicare GLP-1 Bridge program. This program is administered by CMS and is separate from your Part D benefit. Please contact your healthcare provider or visit the program website here for more details.
 
*Please refer to your Evidence of Coverage and other plan materials for any deductible that may apply. 

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Formulary Id: 26329
Formulary Effective Date: 07/01/2026
Updated:
07/2026

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