Medicare Part D coverage is a federal program that helps pay for prescription medication. Under OneCare-HMO, your pharmacy benefits are covered. OneCare benefits include no co-payments on generic drugs and no co-payments on brand-name drugs until your total yearly drug costs reach $2,000.

A formulary is a list of covered drugs under OneCare. OneCare will generally cover the costs of drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a OneCare network pharmacy and other plan rules are followed.

New members to OneCare may be taking drugs not on our formulary or subject to certain restrictions. Members should talk to their PCP to decide if they can switch to an appropriate drug we cover or request an exception. Current OneCare members may also request an exception if their PCP prescribes a drug not covered.

OneCare-HMO members have rights under Medicare to file a grievance or an appeal. Also, members with limited income and resources may qualify for assistance to help pay for prescription drugs.