Medica may add or remove drugs from Medica’s Medicare Part D formulary during the year. Before removing drugs from the formulary or adding prior authorization, quantity limits and/or step therapy restrictions on a drug, Medica will notify providers of the change via this website at least 60 days before the date that change becomes effective. Exceptions to this would be when the US Food and Drug Administration deems a drug on the formulary to be unsafe or when the drug’s manufacturer removes the drug from the market, in which case Medica will promptly remove the drug from the Part D formulary.
When changes are made, the 60 day notices will be listed below, by month. Additionally, they will be published in the
Connections newsletter and affected members will be notified of the changes in their monthly statements, referred to as their Part D Explanation of Benefits (EOB).
Annual Medicare Part D Formulary Change Notifications:
60 Day Medicare Part D Formulary Change Notifications: Physicians can submit a medication request form (MRF), listed below, when requesting a formulary exception on behalf of a Medica member. It is important for the physician to fill the form out as completely as possible, and cite what medications have been tried and failed. This includes the dosages used and the reason for failure (i.e. side effects or lack of efficacy).