Upmc for life drug formulary 2023

Pharmacy Services is available from. 8 a.m. to 6 p.m., Monday through Friday, and Saturday from 8 a.m. to 3 p.m. Providers may submit coverage determination requests to Pharmacy Services electronically online at upmc.promptpa.com, by calling 1-800-979-8762, or by sending a fax to 412-454-7722.

UPMC for Life HMO Premier Rx Premium, Deductible, and Out-of-Pocket Limit Monthly plan premium $0 per month Annual deductible No deductible $5,500 for Medicare-covered services, including copays and coinsurance; Your out-of-pocket spending limit for the year. This is not a deductible and does not include costs for Part D prescription drugs.Find participating UPMC Community HealthChoices pharmacies. Participants who need help finding a pharmacy, or have questions about their prescription coverage, can call the UPMC Community HealthChoices HealthCare Concierge team at 1-844-833-0523 (TTY: 711). UPMC Community HealthChoices offers prescription drug coverage for participants.UPMC for Life plans do not have a deductible for prescription drugs. If your plan does have a deductible, you will pay the full price for your drugs until you meet your Part D deductible. Your plan begins to pay for your covered prescriptions. You pay a copay or coinsurance, depending on the drug tier, until your total yearly costs reach $5,030. We would like to show you a description here but the site won’t allow us. UPMC for Life Prescription Drug Transition Process What should I do before I can talk to my doctor about changing my prescription drugs or requesting an exception to the UPMC for Life formulary?. As a new member to our plan, you may be taking medications that are not on our formulary, or you may be taking a medication that is on our formulary but … UPMC Prospective Members. Call us toll-free: 1-866-400-5077 TTY: 711. 1-866-400-5077 (TTY: 711) for Life for Life. 1-877-539-3080 (TTY: 711). for Life for Life for Life. As a member of UPMC for Life, you have access to top-ranked care, award-winning customer service, renowned health and wellness programs, and so much more. This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract …Online Original Medicare, look in your current “Medicare & You” handbook that you received in the fall. You can view it online at www.medicare.gov or get a copy by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days. Member aIDCard week. TTY users should call. 1-877-486-2048.

Pittsburgh (Oct. 1, 2021) – UPMC Health Plan today announced its 2022 offerings for UPMC for Life, which include Medicare Advantage (MA) plans with options to customize dental, vision or over-the-counter coverage and the debut of four new plans: one tailored to serve the needs of Medicare-eligible veterans, a plan with enhanced prescription drug …2023 UPMC for Life plans. UPMC for Life is proud to offer a variety of high-quality, affordable Medicare plans for the upcoming year. Our plans help Medicare beneficiaries get easy access to the care they need with important extra benefits and outstanding customer service. Now you have more opportunities to grow your book of business than ever ...UPMC for Life PPO Rx Choice (PPO) is a Medicare Advantage (Part C) Plan by UPMC for Life. Premium: $23.00. Enroll Now. This page features plan details for 2023 UPMC for Life PPO Rx Choice (PPO) H5533 – 014 – 0 available in Western Pennsylvania. IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link ...If you are a resident of a long-term care facility, we will cover a temporary transition supply of at least 31 days of medication. If you need a medication that is not on our formulary or is subject to additional authorization, but you are past the first 90 days of membership in our plan, we will cover up to a 31-day emergency supply of that ...For UPMC for Life Complete Care (Medicare Specialized Needs Plans) members: 2024 UPMC for Life Complete Care Formulary (PDF) For UPMC since Kid (CHIP) members: UPMC by Kids – Drug Inventory. UPMC required Kids Formulary Drug Pick (PDF) For UPMC Community HealthChoices members: UPMC Community HealthChoices – Drug …Online Original Medicare, look in your current “Medicare & You” handbook that you received in the fall. You can view it online at www.medicare.gov or get a copy by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven. Member IDCard days a week. TTY users should call. 1-877-486-2048.

All UPMC for Life Complete Care members have a $0 copay for all covered formulary prescription drugs at participating pharmacies! This applies to all levels of …services. See the UPMC for Life Flex Spend Card under Extra Benefits and Services for more details. Medicare-covered: $30 per visit; Medicare-covered: $30 per visit; Vision services4 30% of the cost for one routine vision exam and one contact lens fitting exam every year $0 for one routine vision exam and one contact lens fitting exam every yearProviders should contact Clinical Operations/Utilization Management at 412-454-2765, Monday through Friday from 8 a.m. to 5 p.m. ♦ Disclaimer: Policies and procedures designated with a ♦ are pending approval by the Department of Human Services (DHS) and are not currently approved for use for the Medical Assistance product.2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered ...2023 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/30/2022. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week.

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UPMC for Life members: UPMC for Life HMO/PPO combined provider directory, Last updated 4/12/2024. UPMC for Life Complete Care (HMO SNP) provider directory, Last updated 4/12/2024. UPMC for Life pharmacy directory, Last updated 4/12/2024. UPMC for Life PPO Premier Rx (PPO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included. Part B. Part C. Part D. Part B Give Back. Total. $174.70. Total Number of Formulary Drugs: 3,869 drugs: Browse the UPMC for Life HMO Deductible Rx (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • …UPMC Health Plan. Attn: UPMC for Life. U.S. Steel Tower, 9th Floor. 600 Grant Street. Pittsburgh, PA 15219. This information is not a complete description of benefits. Call 1-844-575-8241 (TTY: 711) for more information. This information is available for free in other languages. Please call our customer service number at 1-800-606-8648 (TTY: 711). We would like to show you a description here but the site won’t allow us.

This content requires JavaScript. Please enable JavaScript. Medicare Open Enrollment - Pharmacy Benefit Plans. This content requires JavaScript. Please enable JavaScriptTotal Number of Formulary Drugs: 3,769 drugs: Browse the UPMC for Life HMO Rx Enhanced (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. This plan offers select insulin at a $35 copay. Learn more. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing …由於此網站的設置，我們無法提供該頁面的具體描述。UPMC Health Plan recommends that you contact the providers listed in this directory to confirm that the information remains current. Individuals & Families. Medicare. Employers. Providers. Member Benefits. About Us. Find Care. Find a Medication.2023 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/30/2022. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week.UPMC Community Pharmacies provide a variety of services for patients throughout the region, including traditional retail medications, home infusion therapy, specialty pharmacy, institutional pharmacy, and home enteral nutrition. Visit the UPMC at Home website to learn more. Learn more about our Centre Avenue Community Pharmacy.As a provider-led health plan, we’ve created a unique laboratory to align incentives, deliver better care, and improve the health of our members. Read about our latest innovations that control costs and improve health outcomes. UPMC Health Plan offers access to the best hospitals, best doctors, and best customer service for individuals ...Total Number of Formulary Drugs: 3,869 drugs: Browse the UPMC for Life Complete Care (HMO D-SNP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 ...

Plan ID: H3907-37-0. UPMC for Life HMO Deductible Rx (HMO) 2024 UPMC for Life HMO Deductible Rx (HMO) H3907 — 037— 0 is a Medicare Advantage plan with drug coverage. It has received a 5-out-of-5 star rating from CMS for 2024. Learn more about UPMC for Life HMO Deductible Rx (HMO) H3907 - 037 - 0, including the health and drug services it ...

Your pharmacy benefit plan may cover additional medications and supplies and may exclude medications that are otherwise listed on your formulary. Your benefit plan may …AND have eight or more chronic/maintenance Part D covered drugs within a 90-day period, AND are likely to incur annual costs that meet or exceed $5,330 for all covered Part D drugs. (UPMC for Life estimates that members whose drug costs equal or exceed $1,332.50 in a 90-day period will have an annual drug cost of at least $5,330.)You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 2017, and from to time during the year. UPMC for Life has a contract with Medicare to provide HMO and PPO plans. Enrollment in UPMC for Life depends onOnline Original Medicare, look in your current “Medicare & You” handbook that you received in the fall. You can view it online at www.medicare.gov or get a copy by calling 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. TTY users should call. Member IDCard. 1-877-486-2048.Drug use policies and formulary management. Regulatory affairs. Analytics and outcomes. Quality and Drug Safety. The UPMC Pharmacy Department has a commitment to assuring excellence in drug safety and quality. The medication safety officer (MSO) works with others to frequently assess the drug management system to implement safety best …Cigna Formulary?” › Drugs removed from the market. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug. › Other changes. We may make other changes thatUPMC for Life HMO Rx Choice (HMO) is a Medicare Advantage (Part C) Plan by UPMC for Life. Premium: $36.00. Enroll Now. This page features plan details for 2023 UPMC for Life HMO Rx Choice (HMO) H3907 – 049 – 0 available in Western, Central, and North Eastern Pennsylvania. IMPORTANT: This page features the 2023 version of this plan.Phone: UPMC for Life HMO/PPO members can call our Member Services Department at 1-877-539-3080 (TTY: 711) seven days a week from 8 a.m. to 8 p.m. UPMC for Life Complete Care (HMO SNP) members can call 1-800-606-8648 24 hours a day, 7 days a week.

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Your pharmacy plan gives you access to a broad network of retail pharmacies nationwide, including CVS, Rite Aid, Sam’s Club, and Walmart; regional chain pharmacies such as Giant Eagle, GIANT, MARTIN’S, and Wegmans; plus hundreds of independent pharmacies. When you take your prescription to any in-network pharmacy, the pharmacist will ...Online Original Medicare, look in your current “Medicare & You” handbook that you received in the fall. You can view it online at www.medicare.gov or get a copy by calling 1-800 …Get 2023 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCUnder Your Insurance on the homepage, click UPMC for Life Flex Spend Card. Then click UPMC for Life Flex Spend Card Portal. Once on the portal, click Reimburse Myself. By fax: Fax a completed reimbursement form and proper documentation to 1-844-361-4700. By mail: Mail a completed reimbursement form and proper documentation to UPMC Health Plan ...UPMC for Life HMO Premier Rx (HMO) is a Medicare Advantage (Part C) Plan by UPMC for Life. Premium: $0.00. Enroll Now. This page features plan details for 2024 UPMC for Life HMO Premier Rx (HMO) H3907 – 052 – 0 available in Berks, Cumberland, Dauphin, Lancaster, and York. IMPORTANT: This page has been updated with plan and premium …U.S. Office of Personnel Management22MCID2721 - Q2 Flex Spend Card Catalog Updates. 1 / 56. Flipsnack player.2 Drugs 3 Controlled Drugs 4 Medical Devices 5 Cosmetics 6 Inspections 7 Compliance & Accreditation 8 Others Inspection & Research 1 Science and Research 2 GXP …Other physicians/providers are available in the UPMC for Life network. This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. If you require a prior authorization for a medication not listed here, please contact UPMC Health Plan Pharmacy Services at 1-800-979-UPMC (8762). If you are unable to locate a specific drug on our formulary, you can also select Non-Formulary Medications, then complete and submit that prior authorization form. Medical directors are available to ... U.S. Office of Personnel Management ….

UPMC for Life Flex Spend Card and Over-the-Counter (OTC) Mail-Order Catalog Your health care dollars, your choice! 202 3 5103 1234 5678 9010 GOOD THRU 12/23 J SMITH FLEX SPEND CARD ... (PCP) copays, specialist copays, prescription drug copays, or premiums ...Contact Us. Health Care Concierge Services 1-800-286-4242 (TTY: 711) Prospective Members 1-888-424-2972 (TTY: 711) Our Health Care Concierge team is available to assist you Monday, Tuesday, Thursday, Friday from 7 a.m. to 7 p.m., Wednesday from 7 a.m. to 8 p.m., and Saturday from 8 a.m. to 3 p.m.UPMC for LifeComplete Care (HMO SNP) H4279_233011_M. 2023 Summary of Benefits Western, Central, and North Eastern PA. Get started with UPMC for Life. Here is a summary of what our plans cover and what you pay for care. These benefits are effective Jan. 1, 20 23 – Dec. 31, 20 23. This booklet does not list e very servic e that w …TRICARE covers most prescription drugs approved by the Food and Drug Administration (FDA). Prescription drugs may be covered under the pharmacy benefit or the medical benefit. We review and update the TRICARE Formulary each quarter. After each review, some drugs may move from one category to another. You’ll get a letter …If you have questions about your benefits, call the UPMC for You Health Care Concierge team at 1-800-286-4242 (TTY 711). Representatives are available Monday, Tuesday, Thursday, and Friday from 7 a.m. to 7 p.m.; Wednesday from 7 a.m. to 8 p.m.; and Saturday from 8 a.m. to 3 p.m. Access helpful resources for UPMC for You members. UPMC for Life plans do not have a deductible for prescription drugs. If your plan does have a deductible, you will pay the full price for your drugs until you meet your Part D deductible. Your plan begins to pay for your covered prescriptions. You pay a copay or coinsurance, depending on the drug tier, until your total yearly costs reach $5,030. Virtual visits anytime, anywhere—covered at 100 percent—through UPMC AnywhereCare. 4 The UPMC Health Plan mobile app , which puts your insurance information in the palm of your hand. You can use it to access digital member ID cards for you and your family, live chat with a Health Care Concierge, track recent claims, and more.This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract … We would like to show you a description here but the site won’t allow us. This content requires JavaScript. Please enable JavaScript. Medicare Open Enrollment - Pharmacy Benefit Plans. This content requires JavaScript. Please enable JavaScript Upmc for life drug formulary 2023, The Department of Human Services ("the department") maintains a Statewide Preferred Drug List (PDL) to ensure that Medical Assistance (MA) program beneficiaries in the Fee-for-Service (FFS) and HealthChoices/Community HealthChoices Managed Care Organization delivery systems have access to clinically effective pharmaceutical care with an ... , Large Group Businesses. Value Choice. USelect. Global Health Plan. Non Health Insurance. Daman Gratuity and Employee Benefits Plan. Manage Insurance. Manage Insurance. Empowering Your Peace of Mind with Expert Insurance Management., Under Your Insurance on the homepage, click UPMC for Life Flex Spend Card. Then click UPMC for Life Flex Spend Card Portal. Once on the portal, click Reimburse Myself. By fax: Fax a completed reimbursement form and proper documentation to 1-844-361-4700. By mail: Mail a completed reimbursement form and proper documentation to UPMC Health Plan ..., Also new in 2023 are discounts on hearing aids through Amplifon, a new UPMC for Life provider. This benefit is expected to save members an average of $6,734 on hearing aids., depending upon device selection. Members can also take advantage of free hearing exams and free hearing aid fittings covered through UPMC for Life MA plans., Manage appointments, communicate with your doctor, pay bills, renew prescriptions, and view your medical records and lab results with MyUPMC., This content requires JavaScript. Please enable JavaScript. Medicare Open Enrollment - Pharmacy Benefit Plans. This content requires JavaScript. Please enable JavaScript, Online Original Medicare, look in your current “Medicare & You” handbook that you received in the fall. You can view it online at www.medicare.gov or get a copy by calling 1-800 …, Drug Formulary. Plan Overview. Medical Deductible. Individual: $1,000; Family ... So you're looking to buy life insurance. First, pat yourself on the back. It…, This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract …, Find participating UPMC Community HealthChoices pharmacies. Participants who need help finding a pharmacy, or have questions about their prescription coverage, can call the UPMC Community HealthChoices HealthCare Concierge team at 1-844-833-0523 (TTY: 711). UPMC Community HealthChoices offers prescription drug coverage for participants., Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC ..., Contact Us. Health Care Concierge Services 1-800-286-4242 (TTY: 711) Prospective Members 1-888-424-2972 (TTY: 711) Our Health Care Concierge team is available to assist you Monday, Tuesday, Thursday, Friday from 7 a.m. to 7 p.m., Wednesday from 7 a.m. to 8 p.m., and Saturday from 8 a.m. to 3 p.m., UPMC for Life Prescription Drug Transition Process What should I do before I can talk to my doctor about changing my prescription drugs or requesting an exception to the UPMC for Life formulary?. As a new member to our plan, you may be taking medications that are not on our formulary, or you may be taking a medication that is on our formulary but …, H3907 - 057 - 1. (5 / 5) UPMC for Life HMO Rx Choice (HMO) is a Medicare Advantage (Part C) Plan by UPMC for Life. Premium: $36.00. Enroll Now. This page features plan details for 2024 UPMC for Life HMO Rx Choice (HMO) H3907 – 057 – 1 available in Allegheny County. IMPORTANT: This page has been updated with plan and premium data for 2024., UPMC for Life PPO Rx Choice (PPO) is a Medicare Advantage (Part C) Plan by UPMC for Life. Premium: $23.00. Enroll Now. This page features plan details for 2023 UPMC for Life PPO Rx Choice (PPO) H5533 – 014 – 0 available in Western Pennsylvania. IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link ... , H3907 - 057 - 1. (5 / 5) UPMC for Life HMO Rx Choice (HMO) is a Medicare Advantage (Part C) Plan by UPMC for Life. Premium: $36.00. Enroll Now. This page features plan details for 2024 UPMC for Life HMO Rx Choice (HMO) H3907 – 057 – 1 available in Allegheny County. IMPORTANT: This page has been updated with plan and premium …, Medicare Advantage plan information for UPMC for Life HMO Rx Enhanced (HMO) by UPMC for Life. Skip to content. Plans . Medicare Advantage and ... provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered. Drug Deductible: $0.00: Initial Coverage Limit: $5,030.00: Catastrophic Coverage Limit ..., Dec 14, 2023 · Please call our customer service number at 1-800-606-8648 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. , UPMC Health Plan recommends that you confirm with the selected provider that the information found in the directory remains current. The directory does not list a provider’s race or ethnicity, but some providers have disclosed this information. If you would like assistance finding a provider of a particular race or ethnicity, please contact ..., 2 Drugs 3 Controlled Drugs 4 Medical Devices 5 Cosmetics 6 Inspections 7 Compliance & Accreditation 8 Others Inspection & Research 1 Science and Research 2 GXP …, We’ve compiled some that you may need as a UPMC Health Plan member, along with other helpful ... prescription drug coverage and more. Additional Benefits. Prescription Drug Coverage; Dental, Vision, and Hearing; We designed the Standard Option HMO plan to ... 2023 Pharmacy Formulary; 2024 Pharmacy Formulary; Prescription Drug Rider ..., Total Number of Formulary Drugs: 3,869 drugs: Browse the UPMC for Life HMO Premier Rx (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred ... , UPMC for Life is UPMC Health Plan’s Medicare Program. UPMC for Life Complete Care (HMO SNP) offers medical as well as prescription drug coverage in a single easy-to-use plan. Members who are eligible for Medicare and Medicaid may avail this valuable coverage including extra benefits and services as follows: Health Care Concierge, Gostaríamos de lhe mostrar uma descrição aqui, mas o site que está a visitar não nos permite., UPMC Health Plan recommends that you confirm with the selected provider that the information found in the directory remains current. The directory does not list a provider’s race or ethnicity, but some providers have disclosed this information. If you would like assistance finding a provider of a particular race or ethnicity, please contact ..., Total Number of Formulary Drugs: 3,869 drugs: Browse the UPMC for Life HMO Rx Choice (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy, The Department of Human Services ("the department") maintains a Statewide Preferred Drug List (PDL) to ensure that Medical Assistance (MA) program beneficiaries in the Fee-for-Service (FFS) and HealthChoices/Community HealthChoices Managed Care Organization delivery systems have access to clinically effective pharmaceutical care with an ..., Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC ..., Total Number of Formulary Drugs: 3,769 drugs: Browse the UPMC for Life HMO Premier Rx (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. This plan offers select insulin at a $35 copay. Learn more. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during ..., This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711). UPMC for Life has a contract with Medicare to provide HMO, HMO SNP, and PPO plans. The HMO SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract …, Our Federal Employees Health Benefits (FEHB) plans are designed with your needs in mind. When you choose UPMC Health Plan, you get access to: A personalized incentivized rewards program— Take A Healthy Step—that can help you understand and improve your health. RxWell®, a self-guided app you can use to manage your stress, anxiety ..., Name of drug/medication. Strength of the drug (example 5 mg) Quantity being prescribed. Days supply. For Medical Services: Description of service. Start date of service. End date of service. Service code if available (HCPCS/CPT), TRICARE covers most prescription drugs approved by the Food and Drug Administration (FDA). Prescription drugs may be covered under the pharmacy benefit or the medical benefit. We review and update the TRICARE Formulary each quarter. After each review, some drugs may move from one category to another. You’ll get a letter …