Formularies Pharmacies
The following information will help you understand which drugs are covered as well as where you can find participating pharmacies and mail order services available to you.
Note: If you are using an Apple mobile device (iPhone or iPad) please download the FREE Adobe Acrobat Reader app to ensure you can view our formularies.
Find out which drugs are covered with your plan:
- 2023 Pharmacy Benefit Dimensions PDP Part D 3 Tier Formulary
- 2023 Pharmacy Benefit Dimensions PDP Part D 5 Tier Formulary
- 2023 Niagara County PDP Group D0122 Formulary
- 2023 Niagara County PDP Group D0457-0464 Formulary
- 2023 Niagara County PDP Group D0465 Formulary
- 2023 Labor Management Healthcare Fund PDP Formulary
- 2023 City of Stamford PDP Formulary
Prior Authorization Criteria (Pharmacy Benefit Dimensions PDP): Some drugs require you (or your physician) to get prior authorization.
- 2023 Pharmacy Benefit Dimensions PDP Part D 3 Tier Prior Authorization Criteria
- 2023 Pharmacy Benefit Dimensions PDP Part D 5 Tier Prior Authorization Criteria
- 2023 Labor Management Healthcare Fund PDP Prior Authorization Criteria
- 2023 Niagara County PDP Group D0122 Formulary Prior Authorization Criteria
- 2023 Niagara County PDP Group D0457-0464 Formulary Prior Authorization Criteria
- 2023 Niagara County PDP Group D0465 Formulary Prior Authorization Criteria
- 2023 City of Stamford PDP Prior Authorization Criteria
Step Therapy Criteria (Pharmacy Benefit Dimensions PDP): In some cases, Independent Health requires that you first try certain drugs to treat your medical condition before we will cover another drug for that condition.
- 2023 Pharmacy Benefit Dimensions PDP Part D 3 Tier Step Therapy Criteria
- 2023 Pharmacy Benefit Dimensions PDP Part D 5 Tier Step Therapy Criteria
- 2023 Labor Management Healthcare Fund PDP Step Therapy Criteria
- 2023 Niagara County PDP Group D0122 Formulary Step Therapy Criteria
- 2023 Niagara County PDP Group D0457-0464 Formulary Step Therapy Criteria
- 2023 Niagara County PDP Group D0465 Formulary Step Therapy Criteria
- 2023 City of Stamford PDP Step Therapy Criteria
Formulary Quantity Limits (Pharmacy Benefit Dimensions PDP): Certain drugs have a quantity limit, which means we’ll provide coverage only up to the limit specified.
- 2023 Pharmacy Benefit Dimensions PDP Part D 3 Tier Quantity Limits
- 2023 Pharmacy Benefit Dimensions PDP Part D 5 Tier Quantity Limits
- 2023 Labor Management Healthcare Fund PDP Quantity Limits
- 2023 Niagara County PDP Group D0122 Formulary Quantity Limits
- 2023 Niagara County PDP Group D0457-0464 Formulary Quantity Limits
- 2023 Niagara County PDP Group D0465 Formulary Quantity Limits
- 2023 City of Stamford PDP Quantity Limits
2023 Plan Transition Process PDP: If you are new to the plan, we can help you transition when your current drugs are not on the formulary or your ability to get your drugs is limited.
You are covered both locally and nationally with our extensive pharmacy network. For the full list of participating locations, view our pharmacy directory:
Members of Pharmacy Benefit Dimensions PDP can utilize mail order pharmacy services through Wegmans and ProAct Mail Order Pharmacy.
Learn more about Wegmans Mail Order Pharmacy Services and ProAct Mail Order Pharmacy Services and get helpful tips on how to use your mail order pharmacy.
Registration Forms
Pharmacy Benefit Dimensions is a subsidiary of Independent Health. Independent Health is a PDP with a Medicare contract. Enrollment in Pharmacy Benefit Dimensions PDP depends on contract renewal between Independent Health and CMS.
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Last Updated 01/01/2023