Pharmacy Benefits
Make the most of your Part D Pharmacy Benefits.
As a Mass Advantage member, you have access to a wide range of affordable, effective prescription medications and pharmacy services designed to support your health.
Whether your treatment is simple or complex, we’re here to help ensure your medications are safe, work well together, and deliver the best results. If your prescribed drug isn’t on our formulary, we’ll help explore alternatives or exception options.
In 2026 you’ll also benefit from:
- $0 copays for drugs on Tiers 1 and 2
- Cost-sharing capped at $2,100 annually
- Wide network of pharmacies for convenient prescription filling
- Coverage of some medications normally excluded by Medicare
- Support and guidance to help you manage your medications
Mass Advantage pharmacy benefits are built right into your plan—no extra steps, just better access to the care you need.
List of Covered Drugs
All of your prescription details are right here.
Find a Pharmacy
Most local pharmacies accept Mass Advantage, including the major chains like CVS and Walgreens, as well as smaller independent pharmacies. Let’s find a convenient one that works best for you.
Coverage Determination, Appeals and Grievances
Coverage for some drugs may require permission in advance—called Coverage Determination. You can also request a decision be reviewed—called an Appeal. Find information here on coverage determinations, appeals, and grievances.
And a spoonful of sugar...
We also offer extra savings and services to help you get your medications easily and affordably, and take them safely.
Extended-Day Supplies
Fill up to a 100-day supply of your prescription medications at your local retail pharmacy or through one of our convenient mail order pharmacies.
Transition Fills
As a new or continuing member of Mass Advantage, you may qualify for a transition fill. Transition fills let you get temporary supply of drugs that are not on your plan’s formulary or that have certain coverage restrictions (such as prior authorization).
Medicare Prescription Payment Plan
Looking to spread out your Part D prescription drug costs over the course of the year?
Medication Therapy Management (MTM)
Taking a lot of medications? You may be eligible for our MTM program. If you qualify, we will reach out to you to complete a comprehensive medication review and more.
Questions?
We’re here to help.
HMO: (844) 918-0114
PPO: (844) 915-0234
TTY: 711
From October 1 to March 31, we’re available 7 days a week from 8 am to 8 pm EST. From April 1 to September 30, we’re available Monday through Friday from 8 am to 8 pm EST.