Medicare Part D
HealthChoice is contracted with the Centers for Medicare & Medicaid Services to provide Medicare Part D benefits as an Employer Prescription Drug Plan (PDP). An example of the Medicare Part D Identification Card and the Medicare Pharmacy Coverage Determination Request form is available below. Providers must complete this document to request a coverage determination when a medication is not listed in the HealthChoice Medicare Formulary.
Medicare Pharmacy Coverage Determination Request
This is an example of the Medicare Part D Identification Card: