Questions?

Call our Pharmacy Customer Service line, 24 hours a day, 7 days a week.

Call: 1-855-408-0010
Fax: 1-866-250-5178

For questions about MTMP, call the MTMP Hotline directly: 866-342-2183

Drugs not on our Covered Drug List

Virginia Premier CompleteCare (Medicare-Medicaid Plan) may cover a temporary 30-day supply of a drug during the first 90 days of enrollment.  This will give you time to talk to your doctor.  Your doctor can help you  decide if there is an alternative drug on the Covered Drug List that you can use instead, or whether you should request an exception.

To view our transition plan in more detail, please see our Transition Policy.

Part D drugs

A 30-day supply of the drug will be covered if:

  • A drug that you are currently taking is not on our Covered Drug List, or
  • A quantity limit applies to your drug and you are not able to get the amount ordered by your prescriber, or
  • The drug requires prior authorization by approval by Virginia Premier CompleteCare, or
  • A drug that you take is part of a step therapy

Members who are in a nursing home or other long-term care facility

If you live in a nursing home or other long-term care facility:
  • A prescription refill may be covered up to 98 days
  • Refills may be covered multiple times during the 98 days

Non-part D Drugs

Drugs that are not covered by Medicare Part D:
  • All prior authorized drugs and current therapies that you are receiving at the time of enrollment will be honored for 180 days after enrollment.
  • A letter will be mailed to you after the initial fill, directing you on what to do next.
  • On the List of Covered Drugs on our Plan Documents page, non-Part D drugs have an asterisk (*) next to them.
 

Have Questions? Let’s talk.

Call us at 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice). The call is free.

Additional Information

Virginia Premier CompleteCare is a health plan that contracts with both Medicare and the Virginia Department of Medical Assistance Services to provide benefits of both programs to enrollees.

Limitations, copays, and restrictions may apply. For more information, call Virginia Premier CompleteCare Member Services or read the Virginia Premier CompleteCare Member Handbook.

Benefits, List of Covered Drugs, and pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

You can get this information for free in other languages. Call 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice). The call is free.

You can ask for this information in other formats, such as Braille or large print. Call 1-855-338-6467, 8:00 a.m. to 8:00 p.m., Monday through Friday. For TTY/TDD services, please call 1-800-828-1120 (Text), 1-800-828-1140 (Voice).

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