Extra Benefits
We’ve listened to feedback from our members and sales team to make our benefits stronger for the year ahead.
Prescription drug coverage
Making sure your clients know their prescriptions are covered and what they can expect to pay is an important part of the sales process. We want to make it as easy as possible for you to be their best resource for prescription drug options.
2025 Prescription drug formularies
Tip: To easily find a covered drug, have the formulary open in your web browser or computer. Select CTRL+F and then type the name of the drug you are searching for.
You can also find PDFs of our formularies by following these instructions:
- Go to our Find a Medication page.
- Choose the type of health insurance from the dropdown menu.
- Select View the Directory.
- The formulary will open in a new internet tab.
- All covered prescription drugs on the plan you selected will be included and categorized by drug type then alphabetized.
Check a prescription via our Online Searchable Formulary.
2025 Additional prescription drug materials
Additional assistance
- Prior authorization and step therapy— Help your clients find information about our prior authorization and step therapy requirements.
- Low income subsidy (LIS) premium summary table—People with low incomes may apply for Extra Help to pay their prescription drug costs. Many people are eligible for these savings and don’t even know it. Find out if your clients are eligible by contacting the Broker Resource Center at 1-855-289-3197 or contact your designated broker manager. View the Low income subsidy (LIS) premium summary table (PDF) for more information.
To sign up for Extra Help or to inquire about low income subsidy status:
- Visit the Social Security Administration online.
- You can also call 1-800-722-1213 Monday through Friday from 7 a.m. to 7 p.m. TTY users should call 1-800-325-0778.
- You can also call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week.
- Call the state Medical Assistance office.