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  • Home Medicare Member Resources and Services Medicare Drug List Formulary

    Medicare Drug List Formulary

    Our formulary is a comprehensive list of commonly prescribed drugs that are covered by your Medicare Advantage (MA) or Part D Prescription Drug (PDP) plan. Cigna Healthcare doctors and pharmacists pick these drugs for their effectiveness, safety, ease of use, and cost.

    Covered Drug Lists

    View the drug lists below to see if your medication is covered depending on your plan. If your medication appears on the drug list, then it is a covered medication under that plan. Your medication might have certain requirements, such as prior authorization or step therapy. You can use the list to check for other medications that treat your condition.

    To view medication pricing, compare costs, and find prescription alternatives, use the Medicare Prescription Pricing and Comparison Tool.

    Cigna Healthcare Medicare Advantage Drug List

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    Prior Authorization Criteria

    2024 Prior Authorization Criteria

    Prior authorization means that some treatments and drugs may need approval from Cigna HealthcareSM before you receive care.

    Cigna Healthcare Medicare Advantage Plans [PDF]

    Updated 03/01/2024

    Step Therapy Criteria

    2024 Step Therapy Criteria

    Step therapy is when you have to try lower cost drugs before Cigna Healthcare approves a more expensive drug.

    Cigna Healthcare Medicare Advantage Plans [PDF]

    Cigna Healthcare Medicare Advantage Plans - Part B Drugs [PDF] - Updated 11/16/2023

    Cigna Healthcare Medicare Advantage Plans - Part B Drugs [PDF] - Effective 04/01/2024

    Updated 03/01/2024

    Part D Drug List

    Each Medicare Part D Prescription Drug Plan must follow the rules set forth by Medicare for covering Part D drugs and be approved by Medicare each year. Medicare Part D Prescription Drug Plans must include at least two drugs in every drug category. In addition, each Medicare Part D Prescription Drug Plan must:

    • Make sure you have convenient access to retail pharmacies
    • Have a process to request exceptions to the drug list
    • Provide useful information to you, such as how drug lists and medication management programs work, information on saving money with generic drugs, and grievance and appeal processes

    Not all prescription drugs are included on the drug list. In some cases, the law prohibits Medicare coverage of certain types of drugs. In other cases, we have decided not to include a particular drug on our drug list because we may have an alternative drug that can be taken.

    Generics

    All Medicare Part D Prescription Drug Plans cover various brand-name drugs and generic drugs. Generic drugs have the same active ingredients as brand-name drugs. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs.

    Prior Authorization Criteria

    2024 Prior Authorization Criteria

    Prior authorization means that some treatments and drugs may need approval from Cigna Healthcare before you receive care.

    Cigna Saver Rx (PDP) Plan [PDF]

    Cigna Secure Rx (PDP) Plan [PDF]

    Cigna Extra Rx (PDP) Plan [PDF]

    Updated 03/01/2024

    Step Therapy Criteria

    2024 Step Therapy Criteria

    Step therapy is when you have to try lower cost drugs before Cigna Healthcare approves a more expensive drug.

    Cigna Saver Rx (PDP) Plan [PDF]

    Cigna Secure Rx (PDP) Plan [PDF]

    Cigna Extra Rx (PDP) Plan [PDF]

    Updated 03/01/2024

    Confused by Medicare terms?

    Look it up in the Cigna Healthcare Glossary

    Medicare Drug Formulary Changes

    During a plan year, Cigna Healthcare may make certain changes to our list of covered drugs. Most changes throughout the year will have a positive impact on customers such as adding new drugs to our drug list, removing restrictions, or moving a medication to a lower cost-sharing tier.

    Plans are limited in their ability to make changes during the year that will have a negative impact on customers. A negative change would be removing a medication, moving it to a higher cost-sharing tier, or adding a new requirement. If there are negative changes, in most cases we will post a notice on this site before the change becomes effective. If you are taking the medication with the change, you will generally be notified on your Explanation of Benefits (EOB) statement. We also may make a change when a new generic becomes available.

    It is important that you check the drug list included in your Annual Notice of Changes (ANOC), or the 2024 Cigna Healthcare Medicare Drug and Pharmacy Search Tool to confirm the coverage of your medications for the next year.

    Transitioning to a New Plan

    Find help if you need to switch to a different drug that we cover or request a formulary exception.

    2024 Prescription Drug Transition Policy [PDF]

    Formulary Frequently Asked Questions

    2024 MAPD Annual Formulary Frequently Asked Questions

    2024 PDP Annual Formulary Frequently Asked Questions

    Additional Plan Information

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    Get guidance from a Cigna Healthcare Pharmacist when you're juggling multiple medications.

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    This information is not intended for people with group-sponsored plans provided by an employer. If you are in a group plan, please visit Group Plans Resources, call the telephone number on your Cigna Healthcare ID card, or contact your plan administrator for more information.
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  • Medicare Advantage and Medicare Part D Policy Disclaimers

    Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group. The Cigna Healthcare names, logos, and marks, including THE CIGNA GROUP and CIGNA HEALTHCARE are owned by The Cigna Group Intellectual Property, Inc. Subsidiaries of The Cigna Group contract with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans (PDP) in select states, and with select State Medicaid programs. Enrollment in a Cigna Healthcare product depends on contract renewal.

    To file a marketing complaint, contact Cigna Healthcare or call 1-800-MEDICARE (), 24 hours a day, 365 days a year, TTY . Please include the agent/broker name if possible.

    Medicare Supplement Policy Disclaimers

    Medicare Supplement website content not approved for use in: Oregon.

    AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We'll provide an outline of coverage to all persons at the time the application is presented.

    Our company and agents are not connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by American Retirement Life Insurance Company, Cigna Health and Life Insurance Company, Cigna Insurance Company, Cigna National Health Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.

    The following Medicare Supplement Plans are available to persons eligible for Medicare due to disability: Plan A in Arkansas, Connecticut, Indiana, Maryland, Oklahoma, Rhode Island, Texas, and Virginia; Plans A, F, and G in North Carolina; and Plans C and D in New Jersey for individuals aged 50-64. Medicare Supplement policies contain exclusions, limitations, and terms under which the policies may be continued in force or discontinued. For costs and complete details of coverage, contact the company.

    This website is designed as a marketing aid and is not to be construed as a contract for insurance. It provides a brief description of the important features of the policy. Please refer to the policy for the full terms and conditions of coverage.

    In Kentucky, Plans A, F, G, HDG, N are available under Cigna National Health Insurance Company, Plans A, F, G, HDF, N are available under Cigna Health and Life Insurance Company and Plans A, B, C, D, F, G, N are available under Loyal American Life Insurance Company.

    Kansas Disclosures, Exclusions and Limitations

    Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-KS, CNHIC-MS-AO-A-KS; Plan F: CNHIC-MS-AA-F-KS, CNHIC-MS-AO-F-KS; Plan G: CNHIC-MS-AA-G-KS, CNHIC-MS-AO-G-KS; Plan N: CNHIC-MS-AA-N-KS, CNHIC-MS-AO-N-KS

    Exclusions and Limitations:

    The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:

    (1) the Medicare Part B Deductible;

    (2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;

    (3) any services that are not medically necessary as determined by Medicare;

    (4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;

    (5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;

    (6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or

    (7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

    Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna Healthcare website.

    Y0036_24_1037312_M | Page last updated 01/01/2024

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