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The Formulary, pharmacy network, and provider network may change at any time. You will receive notice when necessary. Please refer to the Evidence of Coverage document for detailed information on the following topics: Description of Part D Drug coverage, Exceptions to our network coverage, Mail-Order service, Long-term supply of drugs, Cost sharing tiers, Restrictions, Coverage changes, Formulary updates, Drug safety, Drugs not covered by the plan, Drug payment stages, Explanation of Benefits, Drug Costs, Coverage Gap, Catastrophic Coverage, Vaccine Coverage, Late Enrollment Penalty, Grievance, Coverage Determinations and Appeals, Medication Therapy Management (MTM) program, Contract termination, Member rights and responsiblities.
This information is available for free in other languages. Please contact our customer service number at (877) 541-4111 or TTY at (877) 551-4111 from 8 a.m. to 8 p.m. Monday through Friday and daily during the enrollment period.
Esta información está disponible de forma gratuita en otros idiomas. Por favor, póngase en contacto con nuestro número de servicio al cliente al (877) 541-4111 o TTY al (877) 551-4111 de 8 am a 8 pm de lunes a viernes, y todos los días durante el período de inscripción.