Drug Tools: Akamai Advantage Select 2013
HMSA’s formulary is a list of Medicare-approved drugs covered by your health or drug plan.Find a Pharmacy
HMSA has a network of pharmacies. In most cases, prescriptions are covered only if they are filled at a network pharmacy.Drug Comparison Tool
Find out if your drug is covered on HMSA's formulary, find available alternatives, and monitor your benefit status in relation to the Medicare Part D coverage gap (also called the "doughnut hole").HMSA My Account – Drug Tools
Register and log on to HMSA My Account to:
- Find out if there are lower cost alternatives to the medications you’re currently taking.
- See a list of all your prescriptions and how much you’ve spent on medications.
- See the possible side effects and adverse reactions of medications.
- Order prescriptions and refills online and have them delivered to your home through our Mail-Order Prescription Drug Program.
Extra Help, also known as Low-Income Subsidy, is a program that can help you pay for your prescription drug premiums and copayments.Coverage Determination
You may call or write to your plan to request a formal decision or exception about prescribed drug coverage, quantity limits, prior authorization, step therapy, and tiered cost sharing.
You can make an appeal if you disagree with a decision that denies your request for prescription drugs or payment of drugs you received.Prior Authorization, Step Therapy, and Quantity Limits
With Akamai Advantage, prior authorization is required for certain prescription drugs. To help manage our members’ health care costs, Akamai Advantage providers must contact HMSA before prescribing certain drugs. Step-therapy requirements and quantity limits also apply for some drugs. You can review a list of your plan’s drug prior authorizations, step therapy requirements, and quantity limits.Transition Process
Transition Process - EOC Chapter 5, Sec 6.2
Under certain circumstances, HMSA can offer a temporary supply of a prescription drug to you when your drug is not on the Drug List or when it is restricted in some way. Doing this gives you time to talk with your provider and figure out what to do.Medication Therapy Management (MTM) Program
To help you better manage your medication and optimize the therapeutic outcomes, the Medication Therapy Management Program is offered to those who meet the eligibility criteria at no cost. Click on the link to get more information about the program.