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Prescription coverage

HAP is here with zero dollar deductibles for covered prescriptions

Most HAP Medicare Advantage Plans include prescription drug coverage (or Part D) and a $0 annual prescription deductible.  Other highlights include a $0 copay for Tier 6 preventative vaccines during initial coverage level; a $0 copay for Tier 1 drugs purchased at a preferred pharmacy; and, a $0 copay for a 90-day supply of most Tier 1 and Tier 2 drugs purchased from a preferred mail order pharmacy. 

New for 2021, HAP is participating in a voluntary CMS model that enables us to lower our members’ out-of-pocket costs for insulin.  Members will pay no more than $35 for a 30-day supply of select insulins during all Part D phases until the catastrophic level is reached.  Members who have a tier copay that is less than $35 per their plan’s design will pay the lesser copay.  This benefit applies to select insulins on the Part D Formulary (examples are:  Novolog, Novolin, Lantus and Toujeo).  

Note: Benefits for our HAP Empowered Duals (HMO SNP) plan have different coverages and cost-shares than described above.  Please review the plan documents for HAP Empowered Duals (HMO-SNP). 

Find out if you qualify for Extra Help with prescription premium costs

Compare prescription drug benefits and costs

If your medication is covered by your Medicare insurance, you can use our online tool Express Scripts to compare prescription drug benefits across different plans. You also can compare plan options against current medication costs to choose the plan that best meets your needs. To use Express Scripts and see if your medication is covered, select your plan type below:

Medicare Advantage Plans 

HAP Senior Plus (HMO)
HAP Primary Choice (HMO)
HAP Senior Plus Henry Ford Tiered Access (HMO)
HAP Choice Medicare - West Michigan (HMO) Option 1 
HAP Choice Medicare - West Michigan (HMO) Option 2
HAP Senior Plus (HMO-POS) Option 1 
HAP Senior Plus (HMO-POS) Option 2
HAP Senior Plus (PPO) Option 1 
HAP Senior Plus (PPO) Option 2
HAP Senior Plus (PPO) Option 3
HAP Senior Plus (PPO) Option 4
HAP Empowered Duals (HMO SNP)

Will my medication be covered?

If you’re shopping for a Medicare plan, you’re probably wondering if your insurance covers your prescription medication. The easiest way to tell if your medication is covered is to download the 2021 HAP Medicare formulary (PDF). Press Ctrl+F (Command+F for Mac) and type in the name of the drug to see whether it’s included in the covered drug list for your type of plan. The drug name will be highlighted.

Your Medicare Part B (Medical Insurance) does cover some outpatient prescription drugs under specific conditions. Learn more at Medicare.gov.

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Last updated 10/1/2020

To be covered by the plan, you must have your prescriptions filled at either plan retail pharmacies or our mail-order pharmacies. In some cases, prescriptions filled at a non-plan pharmacy may also be covered.

For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. These requirements and limits are described in the Evidence of Coverage for each plan.

The formulary may change at any time. You will receive notice when necessary.

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2020 Health Alliance Plan of Michigan
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Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts. HAP Empowered Duals (HMO SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.

Contact us

  • HAP Medicare Sales:

    (800) 868-9885 (TTY: 711)

  • HAP Senior Plus®

    (800) 801-1770 (TTY: 711)

  • HAP Senior Plus®(PPO)

    (888) 658-2536 (TTY: 711)

  • Alliance Medicare Supplement:

    (800) 873-7526 (TTY: 711)