Pharmacy
Prescription drug coverage (Part D)
Medicare Part D helps pay for prescription drugs, including many brand-name and generic medications. You pay part of the cost, and the plan pays the rest. Most of our Medicare Advantage plans include Part D coverage.
Drug and pharmacy finder
Use our online tool to see if your prescriptions are covered.
Medication tracking form
Here's a helpful form you can use to track your prescriptions. Fill it out completely and bring it with you to your appointment with your doctor.
Printed drug and pharmacy lists
Use these links to see our drug list or to find generic drug equivalents. Drug list information can also be found in your plan's Evidence of Coverage. You can search our drug lists by searching the PDF by medical condition at the beginning or alphabetically by drug name using the index at the end.
- Printable drug list (updated 10/1/2026)
- Lista de medicamentos cubiertos (updated 10/1/2026)
Occasionally, drugs may be removed from the list, or rules about how we cover certain drugs may be updated. When that happens, those changes will be listed in this list.
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Some drugs require prior authorization before they are covered by your plan. If you fail to get authorization first, you may be responsible for paying the entire cost of the medication.
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Some drugs require Step Therapy to guarantee coverage. This means that if both Drug A and Drug B treat the same condition, you may have to try using Drug A before we cover Drug B.
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Download a physical list of pharmacies.
If your drug isn't covered
If you need to get a drug that is medically necessary but is not included as a covered drug under your plan, or if we haven't covered a service claim the way you think we should, we have processes in place to assist you. Generally, we respond to your questions and issues the same day. Sometimes we will need medical records or additional information. In these cases, we are still required to respond to you no later than the timeframes outlined here.
- Requesting pharmacy coverage determinations and prior authorizations: Standard response time is within 72 hours. Expedited response time is within 24 hours.
- Pharmacy appeals or redeterminations: Standard response time is within 7 days. Expedited response time is within 72 hours.
Call if you have questions about coverage
If you have a medically necessary need for a non-formulary drug, you can ask us to make an exception and cover the drug. We respond to exception requests within 72 hours. There are three types of exceptions that you can ask for.
- Coverage for a drug, even if it is not on our drug list
- Waiving coverage restrictions or limits on a drug
- Lowering the tier cost of a drug
If we deny your exception request, we will mail you a letter explaining why your request was denied. This letter will include how you can appeal our decision. You can ask for a standard or expedited appeal.
New members have a 90-day transition period after they enroll in our plan. During this time, you can get a one month supply of your prescriptions that are not on our drug list, or that have step therapy or prior authorization requirements. After you get your month's supply, it is a good time to talk with your provider about a formulary exception or other drugs that may work for you.
If Customer Service confirms that we do not cover your drug, you can do the following:
- Ask your provider if you can switch to another drug that the plan covers. Call Customer Service if you need a list of covered drugs to share with your provider.
- Ask us to make an exception and cover your drug by completing our form:
- Using the Prescription Drug Coverage Determination form, you can also ask for an Expedited Exception (Expedited Decision). If you or your prescriber believe that waiting 72 hours for a standard decision could seriously harm your life, health, or ability to regain maximum function, you can ask for an expedited (fast) decision. If your prescriber indicates that waiting 72 hours could seriously harm your health, we will automatically give you a decision within 24 hours. If you do not obtain your prescriber's support for an expedited request, we will decide if your case requires a fast decision. You cannot request an expedited coverage determination if you are asking us to pay you back for a drug you already received.
Return this form by mail or fax:
Range Health Rx, Attn: Pharmacy Department
P.O. Box 47686
San Antonio, TX 78265-8686
Fax:
1-844-521-6938
You can also purchase your drug and ask for reimbursement by making an exception request.
Return the redetermination form by mail or fax as shown on the form.
If we haven't covered a service claim the way you think we should, you can ask us to reconsider the decision. This is called an appeal. We can help with your appeal by reviewing the situation and even get an independent review for you.
- For standard appeals, we must provide a decision no later than seven days after we get your appeal request.
- Ask for an expedited (fast) appeal when you or your doctor believes that your health could be seriously harmed by waiting up to seven days for a decision. We will give you a decision no later than 72 hours after we get you expedited appeal request.
If your prescribing doctor supports your expedited appeal or requests an expedited appeal for you, we automatically grant you a faster decision. If you request an expedited appeal without support from a doctor, we determine whether or not your health situation requires a fast appeal. In the event we determine your situation does not require a fast decision, we give you a decision within 7 days. We will not expedite an appeal for a drug you already receive.
Request an appeal
- Expedited Appeals: You or your appointed representative should contact us by telephone at 1-844-870-0613 or fax at 1-844-430-6802
- Standard Appeals: You or your appointed representative should complete the proper form
and mail or fax it to:
Mail:
Range Health Rx, Attn: Appeals Department
P.O. Box 775370
St. Louis, MO 63177
Fax:
1-844-430-6802
Next steps
We will review your appeal and give you a decision. If we deny your appeal, you can request an outside review by an independent reviewer not associated with our plan.
If you disagree with that decision, you still have the right to appeal further. We will notify you of your appeal rights if this happens.
Our contact information
If you need help with an appeal, call Customer Service at 1-844-870-0613
Other resources
- Medicare Rights Center, 1-888-HMO-9050
- 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048 (24 hours a day/7 days a week)
If you have a problem with how a service was provided, let us know. This is called a grievance. We will look in to your situation to see how it can be resolved.
If you have a grievance related to:
- prescription plan benefits
- CMS issues
- Exceptions/Coverage Determinations for Part D
- Fraud, Waste, & Abuse related to Part D
- Pharmacy quality of care issues
- Redeterminations for Part D
- other pharmacy related topics such as mail order pharmacy, IVR, pharmacy portal
Please call Customer Service at 1-844-870-0613, available 24-hours a day, seven days a week.
We conduct drug utilization review for all our members to make sure that they are getting safe and appropriate care. These reviews are especially important for members who have more than one doctor who prescribes their medications. We conduct drug utilization reviews each time you fill a prescription and on a regular basis by reviewing our records. During these reviews, we look for medication problems such as:
- Possible medications errors.
- Duplicate drugs that are unnecessary because you are taking another drug to treat the same medical condition.
- Drugs that are inappropriate because of your gender or age.
- Possible harmful interactions between drugs you are taking.
- Drug allergies.
- Drug dosage errors.
If we identify a medication problem during our drug utilization review, we will work with your doctors to correct the problem.
For certain prescription drugs, we have additional requirements or coverage limits. These requirements ensure that our members use their drugs in the most cost effective way and help us control costs. These requirements, developed by a team of doctors and pharmacists, help us provide quality coverage to our members.
PRIOR AUTHORIZATION
We require prior authorization for certain drugs. Your physician or provider will help you get approval from us before you fill your prescription. If they don't get approval, we may not cover the drug.
QUANTITY LIMITS
For certain drugs, we limit the amount we will cover per prescription for a defined period of time.
GENERIC SUBSTITUTION
When there is a generic version of a brand-name drug available, our network pharmacies automatically give you the generic version.
See our drug list to find out which drugs are subject to these additional requirements. You can ask us to make an exception if one of your drugs has additional requirements. See how to request an exception under "How to request an exception if your drug is not on our list" above.
Part D transition
Learn when Part D transition applies to you, how it works, and steps to take.
Medication Therapy Management Program
The Range Health Rx Medication Therapy Management Program (MTMP) helps you get the most from your medications.
Medicare Prescription Payment Plan
Range Health members with Medicare Part D coverage are eligible to sign up for the Medicare Prescription Payment Plan (sometimes called M3P or MPPP).
Low income subsidy premium summary
Monthly plan premium for people who get extra help from Medicare to help pay for their prescription drug costs.