Pharmacy Benefits and Clinical Services

You are viewing services for 2025 Medicare Advantage Coverage

View 2024 Medicare Advantage for this page

Questions? Contact Customer Service at (888) 227-7940

Navigate your Memorial Hermann Advantage HMO prescription coverage and benefits with these tools and resources.

Drug List Formulary


See a complete list of covered, commonly prescribed medications covered by our Medicare plan.

Pharmacy Network


View our pharmacy networks and home delivery options.

Dual Special Needs Plan (DSNP)


A dual special needs plan is a type of health insurance plan for people who have both Medicaid and Medicare. You may see this referred to as “dual-eligible” or a DSNP plan.

Transition Policy


Learn more about how to cover your medications when you are new to our plan or you have a drug that is normally not covered.

Coverage Determination


Certain drugs need prior approval or exceptions to be covered. Learn about coverage determination steps and find forms.

Appeals and Grievances


When and how to request a review of a prescription coverage decision. When and how to file a complaint (grievance) against your Medicare plan.

Over-the-Counter (OTC Program)


Shop for covered OTC products and learn about your benefit.

MTM Program


A free service to help you manage your medications and get help from a Pharmacist.

Drug Management Program


Drug Management Program is a program designed to help you take your pain medications safely.

Medicare Prescription Payment Plan (M3P)


Learn about the new Medicare Prescription Payment Plan program for 2025! (Coming Soon)

Extra Help and LIS


Financial assistance for those with limited income and resources.

Frequently Asked Questions


Additional information and common questions regarding the pharmacy benefits.

Pharmacy Resources and Benefit Forms


Find information easily with our helpful tools and resources.

Have more questions or want to learn more?

Do you have questions, concerns, need more information or documents? Call our Customer Service team today at (888) 227-7940 to learn more about your plan benefits, available resources and member services. Hours of operation are Monday – Friday: 6 am – 7 pm CST , Saturday – Sunday: 7 am – 4 pm CST, and Major Holidays: 7 am – 4 pm CST.

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