Pharmacy

Our goal is to provide you with high-quality, cost-effective options for drug therapy.

To do that, we work with your providers and pharmacists to make sure we cover the most important and useful drugs for a variety of conditions.

Tufts Health Unify covers first-time prescriptions and refills. We also cover some over-the-counter (OTC) drugs with a doctor’s prescription. Covered drugs are free.

What drugs are covered?

To quickly find out if we cover a specific drug, look it up in our List of Covered Drugs, also called the Drug List. We update the Drug List every month. The Drug List applies only to drugs you get at retail and specialty pharmacies. If you are in the hospital, you may get drugs covered that are not on the Drug List.

Some drugs in our List of Covered Drugs require prior authorization and/or step therapy. For more information, please see:

2023

• List of Covered Drugs | Searchable Formulary
• Prior Authorization Requirements
• Step-Therapy Requirements

2024

• List of Covered Drugs | Searchable Formulary
• Prior Authorization Requirements
• Step-Therapy Requirements

Where can I fill prescriptions?

In-network large-chain or independent pharmacies can fill your prescription. You can use our search tool to find a pharmacy near you.

Want to know more?

• Explanation of Benefits (EOB)
• Medication Therapy Management
• Mail Order Prescriptions
• Part B Step Therapy

 

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Disclaimers

Tufts Health Unify is a health plan that contracts with both Medicare and MassHealth to provide benefits of both programs to enrollees. It is for people with both Medicare and MassHealth ages 21 through 64 at the time of enrollment.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook (2023).

Si habla español, tiene disponible los servicios de asistencia de idioma gratis. Llame al 1-855-393-3154 (TTY: 711), siete días de la semana, de 8 a.m. a 8 p.m. La llamada es gratuita.

You can get this document for free in other formats, such as large print, formats that work with screen reader technology, braille, or audio. Call 1-855-393-3154 (TTY:711), seven days a week, from 8 a.m. to 8 p.m. The call is free.

The List of Covered Drugs and/or pharmacy and provider networks may change from time to time throughout the year. We will send you a notice before we make a change that affects you.

Benefits may change on January 1 of each year.

 

H7419_4520_CMS Approved
Page modified on: 3/16/2022 5:35 PM