in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program.MeridianComplete
will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at aMeridianComplete
network pharmacy, and other plan rules are followed.
For more information on how to fill your prescriptions, please review your Member Handbook.
The Formulary Updates document outlines drugs that have been updated, added to, or removed from our current formulary.
Generally, if you are taking a drug on our 2018 formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the 2018 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. Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. It will remain available at the same cost-sharing for those members taking it for the remainder of the coverage year. We feel it is important that you have continued access for the remainder of the coverage year to the formulary drugs that were available when you chose our plan, except for cases in which you can save additional money or we can ensure your safety.
MeridianComplete has no premiums, deductibles, or coinsurance. You may pay a small copay for prescriptions covered by MeridianComplete. The amount of your prescription copay varies based on the level of Extra Help you receive, and whether the prescription is covered by Medicare or Medicaid.
In 2018 for generic drugs covered by Medicare (including brand drugs treated as generic) you will pay either a $0 copay, a $1.25 copay, or a $3.35 copay. In 2018, for brand drugs covered by Medicare, you will pay either a $0 copay, a $3.70 copay, or a $8.35 copay.
If you have any questions or concerns about premiums and/or cost-sharing associated with enrollment in MeridianComplete, or you receive a bill for medical or prescription services, please call Member Services at1-855-580-1689 (TTY 711), Monday - Sunday from 8 a.m. – 8 p.m.
Click here to learn about Medicare Part D coverage determination requests and Part D redetermination requests. The request forms are also located on this page.
To obtain the most complete and up-to-date information, or to obtain a list of alternatives to a drug we do not cover please contact MeridianComplete Member Services at
Page Last Modified: 1/9/2018 1:37:46 PM