Resources for Express Scripts Medicare Prescription Plan Members - Express-Scripts.com

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Resources for Express Scripts MedicareTM Prescription Plan Members

We've changed our name: Medco Medicare Prescription Plan (PDP) is now Express Scripts Medicare (PDP)
Express Scripts Medicare Formulary

The Express Scripts Medicare Part D formularies are reviewed by a Pharmacy & Therapeutics Committee composed of physicians and pharmacists who have been approved by the Centers for Medicare & Medicaid Services (CMS).

The formulary is a list of the prescription drugs that are approved for coverage under the Express Scripts Medicare Plan. Be sure to select the formulary that applies to the member's plan option.

Formulary Changes for Express Scripts Medicare Part D Prescription Drug Plans

View the list of drugs that have quantity limits, step therapy, or prior authorization requirements and the rules that apply to each drug.

Value Plan
Choice Plan
Coverage Review Request Form

To initiate the coverage review process, use the Request for Medicare Prescription Drug Coverage Determination form (PDF file), submit a coverage determination request form online, or call us toll-free at 1.800.935.6103, 24 hours a day, 7 days a week. For the hearing-impaired with a TTY machine, please call 1.800.716.3231.

CMS Request for Medicare Prescription Drug Coverage Determination form (PDF file)

Redetermination Request Form

To initiate an appeal of a previously declined coverage review request, submit a coverage redetermination request form online, or call us toll-free at 1.800.935.6103, 24 hours a day, 7 days a week. For the hearing-impaired with a TTY machine, please call 1.800.716.3231.

More Drug per Dispensing Request Form

Use the More Drug Per Dispensing form (PDF file) to request more drugs per dispensing.