Benefits & Coverage

Pharmacy

Pharmacy Directories

Find a pharmacy near you by viewing our Pharmacy Directory below.

List of Covered Drugs (Formularies)

Formularies (lists of covered drugs) offer members access to both generic and brand name drugs. The formulary includes prescription drugs in every therapeutic class and category.

If you are a Viva Medicare member looking for a list of covered drugs, please go to Member Resources and find your plan resource page.

Home Delivery Pharmacy

Medicare Prescription Payment Plan

We know high drug costs are a big concern for you. In 2026, Viva Medicare is paying a higher share of your prescription drug costs to help put money back in your pocket. You will no longer have a coverage gap (called a “donut hole”), and will pay no more than $2,100 in out-of-pocket costs for Part D drugs.

If you do not take many prescription drugs, you may never reach $2,100 in out-of-pocket drug costs. Members who are prescribed several drugs or take a high-cost drug may reach this amount early in the year. These members may benefit from a new program called the Medicare Prescription Payment Plan. Learn more about Medicare Prescription Payment Plan by downloading our brochure.

What is Medicare Prescription Payment Plan?

Medicare Prescription Payment Plan is a government program that lets Medicare members make monthly payments for high-cost prescription drugs throughout the year (January – December) instead of paying the full amount at the pharmacy when the prescription is filled. While this program may be helpful for some members, it’s important to know all the facts and your options before enrolling in Medicare Prescription Payment Plan.

How does Medicare Prescription Payment Plan work?

You will get a letter if your out-of-pocket drug costs from January to September 2025 were more than $2,100. The letter will tell you about Medicare Prescription Payment Plan and how to enroll in the program. If you are prescribed a drug that makes your out-of-pocket cost $600 or more, your pharmacist may also tell you about Medicare Prescription Payment Plan when the prescription is filled.

Viva Medicare is working with CVS Caremark to manage Medicare Prescription Payment Plan enrollments and billing. Once you enroll in Medicare Prescription Payment Plan, you will be set up on a monthly payment plan. Each month, you pay CVS Caremark by sending a check in the mail or paying online. This payment must be received by the due date. Your payments begin the month after your prescription drug is filled at the pharmacy, and a final payment is due by January of the following year.

It’s important to know that your monthly payment can change to a higher amount if new prescription drugs are filled during the year and added to your Medicare Prescription Payment Plan.

Is Medicare Prescription Payment Plan a good fit for me?

Enrolling in Medicare Prescription Payment Plan does not save you money or lower the cost of the drugs. The program simply allows you to spread your out-of-pocket prescription payments over time. This program is NOT a good fit for you if:

• You get Extra Help from Medicare or are enrolled in the Viva Medicare Extra Value (HMO SNP) plan or Viva Medicare Extra Care (HMO SNP) plan.
• You qualify for a Medicare Savings Program.
• Your yearly drug costs are low.
• Your drug costs are the same each month.
• You’re considering signing up for the payment option late in the calendar year (after September).
• You don’t want to change how you pay for your drugs.

Medicare Prescription Payment Plan may be a good fit for you if you are prescribed a high-cost drug early in the year or take several costly drugs each month.

Sample Monthly Payments

Note: These sample payment plans are used to explain possible scenarios; your payment plan may look different with higher or lower monthly payments, based on the drugs you are prescribed.

In the example below, your out-of-pocket prescription drug cost is $525 in January, February, March, and April and you pay that amount at the pharmacy when you pick up your prescription. After spending $525 per month for four months, you reach your maximum out-of-pocket cost of $2,100 and do not have to pay any more Part D prescription drug costs for the rest of the year.

If you choose to participate in Medicare Prescription Payment Plan, you will pay the amounts shown below:

In this example below, new prescription drugs are filled throughout the year and added to your Medicare Prescription Payment Plan account. While no out-of-pocket costs are paid at the pharmacy when you fill your prescription, your monthly payments increase the last five months of the year.

In this example, as new prescription drugs are added throughout the year, the monthly payment gets higher at the end of the year. Medicare Prescription Payment Plan may not be a good option for you if you do not want higher payments during the holiday season.

How to sign up for Medicare Prescription Payment Plan

If you think Medicare Prescription Payment Plan is a good option for you, take these steps:

1. Fill out the enrollment form found in your member guide or go online to Caremark.com/MPPP to complete the form.
2. You will get a letter confirming your enrollment. The letter will show your payment plan and due date. Remember, your monthly payments will get higher if more prescriptions are added during the year.

Other Ways to Save on Drug Costs

Many members qualify for savings and don’t realize it. If you have limited income and resources, call us at 1-800-633-1542 or toll-free, TTY users please dial 711 to see if you qualify for one of these programs:

Extra Help: A Medicare program that helps pay your Medicare drug costs. Visit medicaid.alabama.gov to find out if you qualify and apply. You can also apply with your State Medical Assistance (Medicaid) office. Visit Medicare.gov/basics/costs/help/drug-costs to learn more.

Medicare Savings Programs: State-run programs that might help pay some or all of your Medicare premiums, deductibles, copayments, and coinsurance. Visit medicare.gov/basics/costs/help/medicare-savings-programs to learn more.

Manufacturer Pharmaceutical Assistance Programs (sometimes called Patient Assistance Programs (PAPs)): Programs from drug manufacturers to help lower drug costs for people with Medicare. Visit cms.gov/medicare/coverage/prescription-drug-coverage/patient-assistance-program to learn more.

It’s important to us that you fully understand how Medicare Prescription Payment Plan and the monthly payment structure works before signing up for this program.