Drug Formularies/Drug Prior Authorization Criteria

Call 855.730.5683 to speak with a customer service representative

CUSTOMER SERVICE HOURS FOR OCT 1 THROUGH FEB 14:
Sunday through Saturday
8:00 a.m. - 8:00 p.m.


CUSTOMER SERVICE HOURS FOR FEB 15 THROUGH SEP 30:
Monday through Friday
8:00 a.m. - 8:00 p.m.

Multi-Language Interpreter Services

Our formularies are lists of covered drugs selected by Lovelace Medicare Plan in consultation with a team of health care providers. They include therapies considered a necessary part of a quality treatment program. Lovelace Medicare Plans will generally cover the drugs listed in our formularies as long as the drug is medically necessary, the prescription is filled at a pharmacy in the Lovelace Medicare Plan network, depending on the plan you choose, and other plan rules are followed.

 

Benefits, formulary, pharmacy network, premium, and/or copayments/coinsurance may change on January of each year.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.

Limitations, copayments, and restrictions may apply.

The contract is in effect for months in which you are enrolled in Lovelace Medicare Plan between January 1, 2013 and December 31, 2013. Medicare must approve our plan each year. Medicare (the Centers for Medicare & Medicaid Services) must approve Lovelace Medicare Plan each year. You can continue to get Medicare coverage as a member of our plan as long as we choose to continue to offer the plan and Medicare renews its approval of the plan.

 

Y0091_421_NP Pending CMS Approval