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MDwise 23268.000

For formulary assistance, please call (800) 910-4691, 24 hours, 7 days a week. To download a comprehensive list of Part D prescribed drugs covered by the plan, please visit www.mdwise.org

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Your formulary coverage, pharmacy network or participating providers may change from time to time. If you are impacted you will receive notification. Premium, co-pay, co-insurance and deductibles may vary based on a member’s level of Extra Help. Please call (800) 910-4691 for additional details.

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 Customer Care 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.


Formulary Effective Date: 09/01/2023

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