The Advantage Freedom Plan is an enhanced plan offered by RxAmerica. The Freedom plan has a $0 deductible, which means you pay only the copay for your drugs beginning with your first prescription of 2009. This plan allows greater access to brand name and non-formulary Part D available drugs. Plan available in all 50 states.
Drug Exclusions
Drugs not covered under Medicare Part D and not available under exception including agents used to treat the following:
- anorexia
- weight loss or gain
- cosmetic purposes or hair growth
- symptomatic relief of cough and colds
- prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations
- outpatient drugs for which the manufacturer seeks to require that associated tests or monitoring services be purchased exclusively from the manufacturer or its designee as a condition of sale
- nonprescription drugs (other than select over-the-counter drugs on RxAmerica's formulary)
- barbiturates
- benzodiazepines
Prior Authorizations
Transition
RxAmerica expects that many enrollees will identify formulary conflicts before their next refill and that the process of transitioning to a formulary alternative or instituting an exception request can start before the member seeks a refill. A one-time only, up to 30-day first fill transition supply of Part D covered drugs will be provided under the benefit during the first 90 days. The member will be notified by the pharmacy when a drug is not on the formulary. Information will be provided to the member describing formulary alternatives, how to make an exception request and how to access the Appeals process.
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