What is the Cigna Medicare formulary?


Quick Answer

The Cigna Medicare formulary is the list of commonly prescribed prescription drugs on the company's Medicare Advantage and Medicare Rx plans, states Cigna-HealthSpring. The insurance company covers the cost of drugs on the formulary if they are medically necessary. The patient fills the prescription at a pharmacy in the company's network, and the doctor, patient and pharmacy all follow the policy's drug coverage rules.

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Full Answer

Cigna-HealthSpring works with a team of health professionals to choose drugs for its formulary that meet its standards for quality treatment, reports the company's website. Medicare must approve the drugs on the list every year and every time it changes. Some laws prevent Medicare coverage of certain drugs. Other drugs may not be on the list because Cigna-HealthSpring selected an different drug for that condition. Each category of drug therapies on the formulary must have at least two drugs, and the list contains both brand-name and generic prescriptions.

Medicare Rx plans provide Medicare Part D coverage, which is only for prescription drugs, according to Cigna-HealthSpring. Medicare Part A covers part of hospital care. Medicare Part B covers doctor's visits and other medical treatment, and Medicare Part C, or Medicare Advantage, covers Part A, Part B and Part D, explains the Center for Medicare & Medicaid Services.

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