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Prescription drug coverage is included on CHPW Medicare Advantage (MA) Plans 1, 2, 3, 4 and Dual Plan (SNP). Our coverage uses a tiered cost-sharing system. You pay either a fixed copay amount or a percentage of the total cost.
Prescription Cost-Sharing Tiers
Tier 1 represents the lowest cost generic drugs and Tier 5 represents the highest cost brand drugs and potent drugs that may require monitoring.
- Tier 1: Preferred Generic – includes lowest cost preferred generic drugs
- Tier 2: Generic – includes preferred generic drugs
- Tier 3: Preferred Brand – includes preferred brand drugs and non-preferred generic drugs
- Tier 4: Non-Preferred – includes non-preferred brand drugs and non-preferred generic drugs
- Tier 5: Specialty Tier – includes high cost and brand name drugs
Prescription Pricing
We can help you decide which tier of coverage you need based on the current medications you take. If you’re a current member, please call 1-800-942-0247 (TTY: 711). For prospective members, please call 1-800-944-1247 (TTY: 711). We’re here for you seven days a week, 8:00 a.m. to 8:00 p.m.
To discuss which prescription medications you need, contact your primary care provider or pharmacist.
And keep in mind—for the lowest copays, use a preferred pharmacy.
2022 MA Dual Plan (HMO SNP)
Please see the prescription drug coverage page for more information about which specific medications are covered.
| Preferred pharmacy options |
|
2022 MA Plans 1, 2, 3, 4 (HMO)
| Preferred pharmacy |
|
| Standard pharmacy |
|
2021 MA Plans
2021 Prescription Tier Pricing| Preferred pharmacy |
|
| Standard pharmacy |
|
Prescription Benefits for MA Dual Plan (HMO SNP)
Please read the prescription drug coverage page for more information about which specific medications are covered.
| Preferred pharmacy options |
|
Get the most of your prescription benefits
Additional highlights include:
- 90-day supply of select medications used to treat chronic conditions (e.g., high blood pressure, diabetes, depression)
- Free home delivery
- Searchable and printable prescription drug formularies (lists of covered drugs)
- Coverage accepted at more 1,000 Washington State pharmacies and more than 50,000 pharmacies nationwide
Eligibility criteria may apply. ➔ Learn more about Prescription Drug Coverage.
We’re here to help.
To ask questions, request print copies of materials, and more, contact Customer Service at 1-800-942-0247 (TTY: 711), 8:00 a.m. to 8:00 p.m., 7 days a week.
Did you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.
