Medications We Cover and How to Find Them
See the full list of generic and brand name drugs covered by MVP Medicare plans that include Part D prescription drug coverage.
2025 Medicare Formularies
The following are formularies that are part of our 2025 Medicare Advantage Plans:
- 2025 Medicare Part D Comprehensive Formulary (PDF) (list of covered drugs) (updated 5/2025)
- Monthly Medicare Formulary Updates (PDF) (updated 5/2025)
- Search for a specific drug and view coverage details
- 2025 Formulario Comprensivo de Medicare Parte D (PDF) (lista de drogas cubiertas) (updated 5/2025)
- 2025 MVP DualAccess (HMO D-SNP) Medicare Part D Comprehensive Formulary (PDF) (list of covered drugs) (updated 5/2025)
- Monthly MVP DualAccess (HMO D-SNP) Formulary Updates (PDF) (list of covered drugs) (updated 5/2025)
- 2025 Formulario Comprensivo de MVP DualAccess (HMO D-SNP) (PDF) (lista de drogas cubiertas) (updated 5/2025)
- 2025 Medicare Part D Employer-Based Plan Formulary (PDF) (list of covered drugs) (updated 5/2025)
What Is a Formulary?
A Formulary is a list of prescription drugs covered by your pharmacy benefit. We generally cover drugs listed in our Formulary as long as they are medically necessary, the prescription is filled at an MVP network pharmacy, and other plan rules are followed.
The MVP Pharmacy & Therapeutics (P&T) Committee developed and approved our Formulary. The P&T Committee includes practicing doctors, representing a variety of medical specialties, as well as practicing pharmacists and clinical health plan staff members, including medical directors and registered pharmacists. A doctor and pharmacist with training and experience in the care of the elderly and disabled are also included on the Committee.
2025 Prescription Coverage Changes
No "Coverage Gap"
There will be only three Part D Payment Stages in 2025: the Deductible Stage (depending on your plan), Initial Coverage Stage, and Catastrophic Coverage Stage. The “Coverage Gap” (or “donut hole” stage), during which drug costs could significantly increase, has been eliminated.
$2,000 Out-of-Pocket Maximum for Covered Prescriptions
In 2025, all Part D plans have an out-of-pocket maximum of $2,000. This means that once you have paid $2,000 for Part D covered prescriptions, you will pay nothing through December 31. This is significantly lower than the 2024 out-of-pocket maximum of $8,000.
Medicare Prescription Payment Plan
This program may be a helpful option to manage your monthly drug costs if you have high expenses early in the calendar year. It does not save you money or lower your drug costs.
Refer to your Evidence of Coverage (EOC) for specific plan information.
Insulin Coverage
Important Message About What You Pay for Vaccines
Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible.
Important Message About What You Pay for Insulin
You won’t pay more than $35 for a one-month supply of each insulin covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible.
$0 Preferred Generic Drugs
We cover many commonly used generic drugs at no cost. Tier 1 of the formulary (Preferred Generic Drugs) includes select drugs to treat diabetes, blood pressure, bone health, and high cholesterol. Browse the tabs below for a list of these drugs, and talk to your doctor to find out if any may be right for you.
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These medications are covered at no cost if you have MVP Medicare Part D coverage:
- Amlodipine tabs
- Atenolol/chlorthalidone tabs
- Atenolol tabs
- Benazepril/hydrochlorothiazide tabs
- Benazepril tabs
- Bisoprolol tabs
- Fumarate/hydrochlorothiazide tabs
- Bisoprolol tabs
- Fumarate tabs
- Carvedilol tabs
- Enalapril tabs
- Maleate/hydrochlorothiazide tabs
- Enalapril tabs
- Maleate tabs
- Fosinopril/HCTfurosemide tabs
- Fosinopril sodium tabs
- Hydrochlorothiazide caps and tabs
- Indapamide tabs
- Irbesartan tabs
- Irbesartan/hydrochlorothiazide tabs
- Lisinopril/hydrochlorothiazide tabs 'Lisinopril tabs
- Lisinopril/hydrochlorothiazide tabs 'Lisinopril tabs
- Losartan potassium tabs
- Losartan potassium/hydrochlorothiazide tabs
- Metoprolol ER
- Metoprolol/hydrochlorothiazide tabs
- Metoprolol tartrate tabs
- Moexipril tabs
- Moexipril/hydrochlorothiazide tabs
- Propranolol tabs
- Quinapril tabs
- Quinapril/hydrochlorothiazide tabs
- Ramipril caps
- Spironolactone tabs
- Spironolactone/hydrochlorothiazide tabs
- Telmisartan
- Trandolapriltriamterene/hydrochlorothiazide caps and tabs
- Valsartan tabs
- Valsartan/hydrochlorothiazide tabs
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These medications are covered at no cost if you have MVP Medicare Part D coverage:
- Glimepiride
- Tabsglipizide
- Tabsglipizide ER tabs
- Glipizide XL
- Metformin tabs
- Metformin ER tabs (generic Glucophage XR only)
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These medications are covered at no cost if you have MVP Medicare Part D coverage:
- Atorvastatin tabs
- Ezetimibe tabs
- Ezetimibe/simvastatin tabs
- Lovastatin tabs
- Pravastatin tabs
- Rosuvastatin tabs
- Simvastatin tabs
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These medications are covered at no cost if you have MVP Medicare Part D coverage:
- Omeprazole capsule 10mg, 20mg and 40 mg
- Pantoprazole tablet 20mg and 40 mg
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Alendronate sodium 35 mg and 70 mg tabs are covered at no cost if you have MVP Medicare Part D coverage.
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These medications are covered at no cost if you have MVP Medicare Part D coverage:
- Euthyrox tablets
- Levo-T tablets
- Levothyroxine tablets
- NP Thyroid tablets
MVP Health Plan, Inc. is an HMO-POS/PPO/HMO D-SNP organization with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in MVP Health Plan depends on contract renewal. MVP Health Plan, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12/31/2024 based on review of MVP Health Plan’s Model of Care. Health benefit plans are issued by MVP Health Plan, Inc., an operating subsidiary of MVP Health Care, Inc. Not all plans available in all states and counties. Every year, Medicare evaluates plans based on a 5-star rating system. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For accommodations of persons with special needs at meetings, call 1-800-324-3899 (TTY 711).
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Last Updated: 10/1/2024
Speak to a Representative
To shop for a plan, contact an MVP Medicare Advisor at 1-800-324-3899 (TTY 711)
For questions about your plan, contact the MVP Medicare Customer Care Center at 1-800-665-7924 (TTY 711). If you have an MVP DualAccess plan, call 1-866-954-1872 (TTY 711).
From April 1-September 30, reach us Monday-Friday, 8 am-8 pm.
From October 1-March 31, reach us seven days a week, 8 am-8 pm.