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Covered Medication List

Information Last Updated: 11/13/2018

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Pharmacy and Formulary Specifics

The formulary is a comprehensive list of Part D prescription drugs that are covered. Part D prescription drugs are available through MedImpact Healthcare Systems large network of pharmacies.

The formulary represents the prescription therapies believed to be necessary in a quality treatment programs and was designed by Brand New Day in consultation with a team of healthcare providers.

Prescribed medications are covered by the Plan as long as the drug is medically necessary and all plan rules are followed. Refer to your Evidence of Coverage (EOC) for additional information on Part D Prescription Drug coverage or call Brand New Day Pharmacy Services.

Plan Year 2018

 
Plan Covered Medication List Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Classic Care Drug Savings (HMO) Plan 25 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Classic Care Drug Savings (HMO) Plan 37 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Classic Choice (HMO) Plan 33 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Embrace Care Drug Savings (HMO C-SNP) Plan 35 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Embrace Choice (HMO C-SNP) Plan 36 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Bridges Drug Savings (HMO C-SNP) Plan 28 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Bridges Choice (HMO C-SNP) Plan 29 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Harmony Drug Savings (HMO C-SNP) Plan 32 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Harmony Choice (HMO C-SNP) Plan 20 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Dual Coverage (HMO D-SNP) Plan 24 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
In Control Drug Savings (HMO C-SNP) Plan 26 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
In Control Choice (HMO C-SNP) Plan 27 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Information Last Updated: 11/5/2018
FIND A PHARMACY
Pharmacy Search

DRUG PRICE CHECK
Find Drug

MEDICATION THERAPY MANAGEMENT PROGRAM
Medication Therapy Management Program
 

Plan Year 2019

 
Plan Covered Medication List Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Classic Care I Plan (HMO) 25 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Bridges Care Plan (HMO CSNP) 28 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Harmony Care Plan (HMO CSNP) 32 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Classic Care II Plan (HMO) 37 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Embrace Care Plan (HMO CSNP) 39-1 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Embrace Care Plan (HMO CSNP) 39-2 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Harmony Choice Plan (HMO CSNP) 20 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Dual Access Plan (HMO DSNP) 24 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Bridges Choice Plan (HMO CSNP) 29 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Classic Choice Plan (HMO) 33 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Embrace Choice Plan (HMO CSNP) 40-1 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Embrace Choice Plan (HMO CSNP) 40-2 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Brand New Day Select Care Plan (HMO ISNP) 41 English

Spanish
Formulary Lookup Tool Pre-Authorization Criteria Step Therapy Criteria
Information Last Updated: 11/12/2018
FIND A PHARMACY
Pharmacy Search

MEDICATION THERAPY MANAGEMENT PROGRAM
Medication Therapy Management Program
 

Changes to Our Formulary

Brand New Day may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we’re removing a drug from our formulary, we’ll either notify affected members 60 days prior to making that change, or notify them when they request a refill of that drug (at which time the member will also receive a 60-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug’s manufacturer removes the drug from the market, we’ll immediately remove the drug from our formulary and provide notice to members taking that drug.

Finding Drugs in the Formulary

To find your prescription drug within the formulary, search by your Plan & Drug name above.

If Your Drug Isn't Listed

Contact our Pharmacy Services Department at 1-866-255-4795 or TTY 711 to discuss options. Or ask your doctor if there's an acceptable alternate medication covered under our formulary.

Related information

Prescription Drug Transition Policy

Part D Prior Authorizations, Coverage Determinations, and Exceptions

Extra Help to Pay for Prescription Drugs – For more information about the BAE policy, contact Member Services at 1-866-255-4795.