2024 年處方集（承� �藥物清單）.pdf

The 2024 Drug Formulary (Covered Drug List) for VillageCareMAX Medicare plans (HMO D-SNP and HMO) was last updated on 09/29/2023. For more information or questions, contact VillageCareMAX Member Services at 1-800-469-6292 (TTY users dial 711), available Monday through Sunday, 8:00 AM to 8:00 PM, or visit www.villagecaremax.org.

Key Points:

1. Vaccine Coverage: The plan covers most Part D vaccines, even if you haven't met your deductible.
2. Insulin Coverage: You'll pay no more than $35 per month for each insulin product, regardless of the cost-sharing tier.
3. Formulary Changes: Most drug coverage changes occur on January 1, but VillageCareMAX can add or remove drugs, move them to different cost-sharing tiers, or add new restrictions throughout the year, following Medicare rules.
4. Exceptions and Appeals: If a change affects your drugs, you or your doctor can request an exception to continue coverage of a brand-name drug. You can also ask for a list of similar drugs that treat your condition.
5. OTC Drugs: VillageCareMAX covers some over-the-counter (OTC) drugs as specified in the OTC benefit.
6. Contact Information: For the most up-to-date formulary information, contact VillageCareMAX Member Services.