Transition Drug Coverage

You can get Transition Drug Coverage when:

For example, you:

1. You’re new to Mass Advantage but are taking a drug that we don’t cover or that has coverage limits

See list of covered drugs and coverage limits

• During your first 90 days on the plan, we’ll cover up to a 30-day supply of your medication. If you live in a long-term care facility, we’ll cover a 31-day supply. 

2. Your plan coverage changes

If coverage changes for a drug you take, we’ll tell you. Each year, you'll receive an Annual Notice of Change (ANOC) for your plan. It explains any coverage changes for the year ahead.

• If any changes affect one of your medications, we’ll cover a 30-day supply of the drug for the first 90 days of the new plan year.
• If you live in a long-term care facility, we’ll cover a 31-day supply.

3. You have a change in your level of care.

• Go home after a stay in a hospital or skilled nursing facility.
• Leave a long-term care facility and return to the community.
• You stop receiving hospice care.

For transitions like these, we’ll cover up to a 30-day supply of your medication. If you live in a long-term care facility, we’ll cover a 31-day supply.

More about Transition Drug Coverage

• We’ll send you a letter that confirms your transition coverage details.
• Once it ends, we can also work with your doctor to explore other options. For example, we can help you find a similar drug that’s covered and works just as well for you.