Prescription Drug Benefits & Formulary
Under Sunshine Health, you have Part D prescription drug coverage to help with the costs of your medications. The majority of your prescriptions will be covered based on the Medicare formulary. If you have any questions regarding whether or not your prescriptions are covered, you can go to the Formulary tab or contact Member Services for additional assistance.
In addition, we can assist you with the following:
- Transitions of prescription drugs
- Out of Network Coverage
- Quality Assurance
- Utilization Management (Prior Authorization/Step Therapy Criteria Requirements)
- Exceptions and Appeals
- Locate a pharmacy near you
- Information about any formulary changes
If there is something in addition that you need which is not found on this site, please contact Member Services. SNP members, please call 1-877-935-8022 (TTY: 711). HMO members, please call 1-844-293-2636 (TTY: 711). From October 1 to February 14, you can call us 7 days a week from 8 a.m. to 8 p.m. From February 15 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. On weekends and holidays, an automated system will handle your call.
Last Updated: 09302016