Pharmacy Plan Coverage

A Comprehensive Formulary is a list of covered drugs selected by HealthTeam Advantage. We generally cover drugs listed in our formulary if it is medically necessary, the prescription is filled at a HealthTeam Advantage network pharmacy, and other plan rules are followed.

You can search for medications on our online formulary or download the Comprehensive Formulary under the 2024 Plan Documents. If you prefer, we will mail you a copy of the most recent version.

• HealthTeam Advantage members call your Healthcare Concierge at 1-888-965-1965 (TTY:711), October 1–March 31, 8 a.m. to 8 p.m. ET, 7 days a week, or April 1–September 30, 8 a.m. to 8 p.m. ET, Monday through Friday. Or send an email to [email protected]
• Prospective members, please call 1-866-267-4386 (TTY: 711), October 1–March 31, 8 a.m. to 8 p.m. ET, 7 days a week, or April 1–September 30, 8 a.m. to 8 p.m. ET, Monday through Friday.

For more information on how to fill your prescriptions, please review your Evidence of Coverage (EOC) document available on the 2024 Plan Documents page.

The Medicare program allows HealthTeam Advantage to make changes in our formulary at any time during the calendar year. A change in our formulary can affect which drugs are covered, the amount of copay, and limits on usage. If the plan makes any negative, non-maintenance formulary change, affected members will receive written notice that explains the change; the formulary on our website will also be updated. For a list of changes made to the formulary, please see the formulary addendum available on the 2024 Plan Documents page.

Formulary Restrictions

Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include prior authorization, step therapy, and quantity limits. For more information on formulary restrictions, see the Formulary Restrictions page or review your Evidence of Coverage (EOC) document or Comprehensive Formulary available on the 2024 Plan Documents.