Get the prescription drugs you need with our pharmacy coverage. 

Our network

You have choices for when and how you order prescription drugs. Our pharmacy network includes retail pharmacies, home-infusion care, long-term care, Indian health service pharmacies, specialty pharmacies and national mail-order pharmacies. For added convenience, you can fill up to a 93-day supply of maintenance medications at your local retail pharmacy.

Some of our network pharmacies provide preferred cost sharing, which may be lower than the cost sharing at a pharmacy that offers standard cost sharing. The Pharmacy Directory will tell you which of the network pharmacies offer preferred cost sharing. Contact us to find out more about how your out-of-pocket costs could vary for different drugs.

See networks

Need to submit a claim?

Find out how to submit a claim.

Submit a claim

See medication coverage

Our formulary is a list that shows you what drugs we cover. It includes generic and brand-name.

Find out about our formulary

Transition policy

If you’re new to our prescription drug plan, you may be taking a medication that’s not part of our formulary (list of covered drugs). 

See our transition policy

Coverage determination

If your pharmacist tells you that a medication requires authorization, you have options.

View coverage determination details

For your safety

We care about your safety. We also care about the service you receive. Find out how we review your experience with in-network pharmacies.

Read about quality assurance

Medication Therapy Management

If you’re taking multiple medications, you may qualify for medication reviews. These identify opportunities to improve your medication plan for your safety.

See if you qualify

Extra help to pay for your prescription drug coverage

You may qualify for Extra Help. This could help lower your monthly costs.

See if you qualify

Last updated Oct. 1, 2023

You are leaving the Moda Health Medicare Advantage website.

Ok Cancel