Pharmacy and Drug Coverage
Know how your pharmacy plan works to get the full advantage of all the benefits we offer.
OptumRx Member Coverage Find a Pharmacy
Medicare Part D Changes
With changes to Medicare Part D in 2025 from the Centers for Medicare & Medicaid Services (CMS), it’s important to review your options.
Pharmacy Tools
As a member you have access to easy to use pharmacy directory tools, formulary drug lists and more.
Find Covered Drugs
Review a complete list of the drugs covered under your plan.
2027
View 2027 Drug Formulary
View 2027 Step Therapy Criteria
View 2027 Drug Prior Authorization Criteria
2026
View 2026 ChoiceElite & ChoicePlus Drug Formulary
View 2026 DUALPartnership Drug Formulary
View 2026 Step Therapy Criteria
View 2026 Drug Prior Authorization Criteria
Apply for a Medicare Prescription Payment Plan
Learn more about the program and see if you're eligible.
Get Prescriptions Delivered to Your Home*
We’ve partnered with Optum Rx to provide prescription home delivery for our members.
Fill out the mail order form below or contact customer service at (844) 642-9090 (TTY: 711) to get more information.
Additional Resources
- Pharmacy Resource Website
- Part B: List of Covered Drugs Requiring a Prior Authorization
- Part B: Prescription Drug Prior Authorization Request or Formulary Exception Form
- Part D: Prior Authorization Request Form
- 2026 Prescription Drug Transition Policy
- Medicare Prescription Coverage Educational Guide
Doctors, pharmacies and drug coverage: Where to start
Here’s what you need to know about doctors, pharmacies and drug coverage with Medicare Advantage.
The basics of Medicare Part D prescription coverage
Medicare Part D prescription coverage is an optional plan that helps cover the cost of prescription drugs. To help you decide if Part D is right for you, learn about coverage basics and what to consider before choosing a plan or deciding not to enroll.
Are prescription drugs covered with Medicare Advantage?
Prescription drug or pharmacy coverage is an important aspect of your health insurance. When you’re eligible for Medicare, there are a variety of ways you can receive prescription drug benefits, depending on the type of Medicare plan you choose.
*Not applicable to Align DUALPartnership plans (HMO D-SNP)
Align powered by Sanford Health Plan is a PPO plan with a Medicare contract. Enrollment in Align powered by Sanford Health Plan depends on contract renewal. Sanford Health complies with applicable federal civil rights laws and does not discriminate, exclude or treat people differently based on race, color, national origin, religion, pregnancy and related conditions, sex (including sexual orientation, gender identity, sex stereotypes, sex characteristics and intersex traits), age, disability, health status, marital status, arrest or conviction record or military participation in the administration of the plan, including enrollment and benefit determinations.
Y0128_ HP-9847-SHPMAWebsite_10-26_M
Last Updated On: 12.31.25 at 1:00 PM