Please note: The 2025 Medicare Formulary consists of six tiers. For more detailed information about your prescription drug coverage, refer to your plan’s Evidence of Coverage by clicking here.
Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you. 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.