Prescription Coverage
Most HAP Medicare Advantage plans include prescription drug (Part D) coverage. Some highlights include $0 copays for Tier 1 drugs purchased at a preferred pharmacy and a $0 copay for a 90-day supply of Tier 1 and Tier 2 drugs purchased from Pharmacy Advantage or a preferred mail order pharmacy in the initial phase of coverage (even if you haven't met your deductible). Tier 1 and Tier 2 drugs include generic drugs for blood pressure, cholesterol and diabetes.
Want to know more?
Check out this video featuring Natalie Pirokla, PharmD, HAP's vice president of clinical strategy & population health, where she explains the Medicare prescription (Part D) benefit details for 2026.
Important message about what you pay for vaccines
Our plans cover most Part D vaccines at no cost to you (even if you haven’t paid your deductible). For more information, call HAP member services at (800) 422-4641 (TTY: 711). You can reach us Monday - Friday from 8 a.m. to 7 p.m.
Important message about what you pay for insulin
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost sharing tier it’s on (even if you haven’t paid your deductible).
Find out if you qualify for extra help with prescription costs.
Compare prescription drug benefits and costs
If your medication is covered by your Medicare Advantage plan, 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 a plan below:
Medicare Advantage Plans 2026
- HAP Medicare Connect (HMO)
- HAP Medicare Superior (HMO)
- HAP Senior Plus Henry Ford Tiered Access (HMO)
- HAP Medicare MedicalAccess (HMO)
- Henry Ford Select (HMO)
- HAP Senior Plus (HMO-POS)
- HAP Medicare Explore (PPO)
- HAP Medicare Prime (PPO)
- HAP Member Assist (PPO)
- HAP Senior Plus (PPO)
- HAP Medicare Complete Duals (HMO D-SNP)
- HAP Medicare Complete Assist (PPO D-SNP)
- HAP Medicare Diabetes and Heart (HMO C-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 HAP Medicare formulary (PDF). Open the PDF and press Ctrl+F (Command+F for Mac). Then 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. Some Part B drugs have a step therapy requirement. For more information, view the HAP Medicare Part B Prior Authorization and Step Therapy Criteria.
Find out if you qualify for extra help with prescription costs.
To be covered by the plan, you must have your prescriptions filled at either plan retail pharmacies or 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.
Health Alliance Plan (HAP) has HMO, HMO C-SNP, HMO-POS, and PPO plans with Medicare contracts. HAP Medicare Complete Duals (HMO D-SNP), HAP Medicare Complete Assist (PPO D-SNP), and HAP CareSourceTM MI Coordinated Health (HMO D-SNP) are Medicare health plans with a Medicare contract and a contract with the Michigan Medicaid Program that provides benefits of both programs to enrollees. Enrollment depends on contract renewals.