Prescription Drugs (Medicare Part D)
In-Network Coverage:
The Health New England (HNE) Medicare Advantage Plan options that include prescription drug coverage provide access to over 65,000 retail pharmacies nation-wide through our Pharmacy Benefit Manager, National Pharmaceutical Services (NPS). HNE Medicare Advantage has contracts with pharmacies that equal or exceed the CMS requirements for pharmacy access in your area.
Out-of-Network Coverage:
Drugs on
the HNE Medicare Advantage Formulary may be covered in special circumstances,
for instance, illness while traveling outside of the plan’s service area where
there is no network pharmacy. You may have to pay more than your normal
cost-sharing amount if you get drugs at an out-of-network pharmacy. In addition,
you will likely have to pay the pharmacy’s full charge for the drug and submit
documentation to receive reimbursement from the HNE Medicare Advantage Plan. For
more details, see your Evidence of Coverage or call one of the numbers listed below.
| Find Your Drug | Find a Pharmacy |
The links below will provide more information on your prescription drug benefit.
- Prescription Drug Copayment Amounts (Medicare Part D)
- Prescription Drug Formulary (Medicare Part D)
- Prescription Drug (Medicare Part D) Limitations/Exceptions
- Request a Coverage Determination or Redetermination and/or Verify Status of Previous Coverage Determination or Redetermination Request
- Extra Help with Prescription Drug Costs
- Prescription Drug Transition Policy (Medicare Part D)
- Quality Management Programs
- Utilization Management Program
- Initial Decisions, Appeals, and Grievances
- Mail Order Program
Can’t Find Your Prescription Drug?
If your prescription drug is not listed in the HNE Medicare Advantage Formulary or you have Prescription Drug Questions, please contact our Pharmacy Benefit Manager at the phone number listed below.
