Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information. Important Message About What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.
We know prescription drug coverage is very important to you. That’s why Johns Hopkins Advantage MD offers a Part D prescription benefit with our plan options.
Important Message About What You Pay for Vaccines –Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.
The Johns Hopkins Advantage MD comprehensive formulary is a complete list of Medicare-approved, prescription brand-name and generic medications we cover.
Important Message About What You Pay for Insulin –You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.
Download the comprehensive formulary or use our formulary search tool to find drugs that are covered by Advantage MD:
We include formulary alternatives in the formulary search tool to help you and your prescribing doctor determine the proper course of action to take when one of your medications is not covered by your plan. To help your doctor decide whether to prescribe a formulary alternative, please download and print your plan’s comprehensive formulary and take it with you when you visit your doctor. Remember, by switching to an alternative generic or brand-name drug included on our formulary, you can avoid paying the full cost for a non-formulary drug.
Note: This is not a complete list of all formulary alternatives covered by your Part D plan. The drugs listed are for comparison purposes and may differ in effectiveness, dosing, side effects and/or drug interaction profiles. Always seek the advice of your doctor regarding your prescription medications.
Our formulary is updated monthly and as formulary changes occur. We may remove drugs from the formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing tier during the plan year. The list of changes that have been made to the formulary is called the errata.
We may immediately remove a brand name drug on our Drug List if, at the same time, we replace it with a new generic drug on the same or lower cost sharing tier and with the same or fewer restrictions. Also, when adding the new generic drug, we may decide to keep the brand name drug on our Drug List, but immediately move it to a different cost-sharing tier or add new restrictions. If you are taking the brand name drug at the time we make the change, we will provide you with information about the specific change(s) we made. This will also include information on the steps you may take to request an exception to cover the brand name drug. You may not get this notice before we make the change.
For other changes to drugs on the Drug List, if the change affects a drug you take, we will notify you in writing at least 30 days before the change is effective or we will give you a 30-day refill on the drug you are taking at a network pharmacy.
However, if the U.S. Food and Drug Administration (FDA) deems a drug on our formulary to be unsafe or if the drug’s manufacturer removes a drug from the market, we will immediately remove the drug from the formulary and notify all affected members as soon as possible.
To view the latest changes that have been made to the formulary, you can download and refer to the errata sheet: