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Medicare members pay the applicable copayment or the cost of the drug, whichever is less, in the Initial Coverage and Coverage Gap Stage. There are certain medications that MCHCP covers at 100%1, when accompanied by a prescription and filled at an Express Scripts Medicare network pharmacy. For more information, see Preventive Services.

  1. Drugs covered at 100% (Generic or Preferred 100 percent, Non-Preferred $100 copayment) are those described in the United States Preventive Services Task Force A and B recommendations, the Advisory Committee on Immunization Practices (ACIP) of the CDC, and HRSA Guidelines for women, as well as children, including the American Academy of Pediatrics Bright Futures periodicity guidelines.

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