Martin’s Point Generations Advantage uses a prescription drug formulary—a list of covered drugs that have been selected in consultation with a team of health care providers.
Generations Advantage plan formularies represent the prescription therapies believed to be a necessary part of a quality treatment program.
Below you will find information relating to your plan's prescription drug formulary.
Martin’s Point Generations Advantage will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at one of our network pharmacies, and other related plan rules are followed.
Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available.
Below you will find links to the formulary (the list of covered drugs) for each plan - available through the Formulary Search Tool and Formulary PDF downloads:
Get to the Formulary Search Tool for your Generations Advantage plan here:
A downloadable PDF copy for each Generations Advantage plan is available for members to download and print at home:
Helpful tips and step-by-step instructions for searching the formulary for a specific prescription drug can be found here:d
Our formulary is reviewed and updated regularly by medical and pharmacy professionals. A formulary may change during the year if we remove drugs from our formulary, add a prior authorization requirement, add quantity limits and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing tier.
Generally, if you are taking a drug on our formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during that same coverage year except when a new, less expensive generic drug becomes available or when new adverse information about the safety or effectiveness of a drug is released.
We must notify you at least 30 days before any of these changes become effective. At the time you request a refill, you will receive a 30-day supply of the drug. Martin’s Point Generations Advantage covers both brand-name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand-name drug. 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.
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.