Pharmacy Benefits and Clinical Services

This page helps our members and providers navigate the Medicare Part D benefit offered through Memorial Hermann Advantage HMO plans.

Questions? Contact Customer Service at (855) 645-8448

Navigate your Memorial Hermann Advantage HMO prescription coverage and benefits with these tools and resources.

Drug List Formulary

See a complete list of covered, commonly prescribed medications covered by our Medicare plan.

Pharmacy Network

View our pharmacy networks and home delivery options.

Dual Special Needs Plan (D-SNP)

A dual special needs plan is a type of health insurance plan for people who have both Medicaid and Medicare. You may see this referred to as “dual-eligible” or a D-SNP plan.

Transition Policy

Learn more about how to cover your medications when you are new to our plan or you have a drug that is normally not covered.

Coverage Determination

Certain drugs need prior approval or exceptions to be covered. Learn about coverage determination steps and find forms.

Appeals and Grievances

When and how to request a review of a prescription coverage decision. When and how to file a complaint (grievance) against your Medicare plan.

Over-The-Counter (OTC Program)

Shop for covered OTC products and learn about your benefit.

MTM Program

A free service to help you manage your medications and get help from a Pharmacist.

Drug Management Program

Drug Management Program is a program designed to help you take your pain medications safely.

Extra Help and LIS

Financial assistance for those with limited income and resources.

Frequently Asked Questions

Additional information and common questions regarding the pharmacy benefits.

Pharmacy Resources and Benefit Forms

Find information easily with our helpful tools and resources.

Have more questions or want to learn more?

Do you have questions, concerns, need more information or documents? Call our Customer Service team today at (855) 645-8448 to learn more about your plan benefits, available resources and member services. Hours of operation are 7 days a week from 8 a.m. to 8 p.m. CT, during October 1 – March 31 and Monday – Friday from 8 a.m. to 8 p.m. CT, during April 1 – September 30.

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