Medicare Part D Drug Plan

ESSENCE Advantage HMO members are automatically enrolled in Medicare Part D drug coverage, featuring $0 yearly deductibles and low prescription drug co-pays. Our coverage of brand name and generic prescription drugs is highlighted in the Summary of Benefits. More detailed explanations can be found in the Drug Formulary and the Evidence of Coverage.

Remember, enrollment in an ESSENCE plan does not affect Medicare coverage for drugs covered under Medicare Part A or Part B. If you meet Medicare's coverage requirements, your drugs will still be covered under Medicare Part A or Part B even though you are enrolled in ESSENCE. See the Medicare & You Handbook for more information about the drugs that are covered by Medicare Part A and Part B.

You can read more information about the CMS policy for best available evidence for proper copay level on the CMS website.

Important Note: ESSENCE members automatically receive their Medicare Part D prescription drug coverage from ESSENCE. If you join another Medicare plan, including a Medicare prescription drug plan, you will be disenrolled from our plan when your enrollment in the new plan begins.

Click here for the Request for Medicare Prescription Drug Determination Request Form.

Click here for the Medicare Part D Coverage Determination Request Form.