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Pharmacy & Prescription Resources 2025

Find what you need to explore and manage your prescriptions, pharmacy, and over-the-counter coverage.

 

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Prescription Drug & Vaccine Coverage

Explore your plan's Part D benefits—including copays, drug tiers, and coverage phases.

Generations Advantage Prime, Select, Value Plus, and Access plans have Part D Prescription Drug coverage built right into the plan. Your prescription coverage is included in your premium. Members also have coverage for common vaccines.

Find out more about your plan's prescription drug and vaccine coverage here:

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Prescription Drug
Formularies

Is your prescription covered? The drug formulary can give you the answers you need.

A formulary is a list of covered drugs selected by Martin’s Point Generations Advantage in consultation with a team of health care providers. It represents the prescription therapies believed to be a necessary part of a quality treatment program.

Explore our plan formularies (including PDF downloads and our Formulary Search Tool) here:

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Pharmacy Network &
Over-the-Counter

Save money on your prescription costs and over-the-counter purchases.

Generations Advantage members can fill prescriptions at any of our 67,000+ network pharmacies. Additionally, our over-the-counter (OTC) benefit provides a quarterly amount that can be used to purchase qualifying OTC items from a local CVS or online.

Learn about our pharmacy network and over-the-counter benefits here:

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Coverage Determinations & Appeals

Understanding the drug coverage determination process, including appeals.

The "initial decision" (coverage determination) is the starting point for members who want a Part D Prescription Drug covered or paid for when the member's doctor or pharmacist says that a certain prescription drug is not covered.

Contact us regarding coverage decisions or get further information about coverage limits here:

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Medication Transition Fill
& MTM Program

Is your prescription not covered under your plan? You may qualify for additional support.

If your drug is not on our formulary, has restrictions, or will no longer be covered and you need help switching to a different drug, a transition fill may help. Martin’s Point also offers a Medication Therapy Management (MTM) Program for qualifying members.

To explore these options, get more information here:

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Get Extra Help for
Prescription Costs

Need extra help paying for your Part D prescriptions? We may have options for you.

If you are a Generations Advantage plan member and having trouble paying for your Part D prescription expenses, we may be able to help.

Find information on Part D cost savings you may qualify for to assist with your plan premiums and Part D Prescription Drug costs here:

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Medicare Prescription Payment Plan

Spread out your prescription drug costs with this new payment option.

Starting in 2025, all Medicare prescription drug plans (Medicare Part D plans) — including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage — will offer enrollees the option to pay out-of-pocket prescription drug costs in the form of capped monthly payments instead of all at once at the pharmacy.

To explore this option or enroll in the program, visit the Medicare Prescription Payment Plan information page:

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Have questions? We're here to help.

If you have questions about your plan, you can talk to a Member Service Representative by calling 1-866-544-7504.

Our representatives are available from 8am–8pm, seven days a week.