List of Covered Drugs

The List of Covered Drugs (Formulary) is a list of drugs that members can get in the HAP Midwest MI Health Link (Medicare-Medicaid Plan).
  • HAP Midwest MI Health Link is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees.
  • Benefits, List of Cover Drugs, and pharmacy and provider networks may change from time to time throughout the year and on January 1 of each year.
  • Generic drugs are made up of the same active ingredients as brand name drugs. They usually cost less than the brand name drug and usually don’t have well-known names. Generic drugs are approved by the Food and Drug Administration (FDA). HAP Midwest MI Health Link covers both brand name drugs and generic drugs.
  • The drugs on the List of Covered Drugs are the drugs covered by HAP Midwest MI Health Link. These drugs are available at pharmacies within our network. A pharmacy is in our network if we have an agreement with them to work with us and provide you services. We refer to these pharmacies as “network pharmacies.”
  • You can always check HAP Midwest MI Health Link’s up-to-date List of Covered Drugs. To view the HAP Midwest MI Health Link Formulary, click on the link below.
The HAP Midwest MI Health Link Formulary (List of Covered Drugs) is available in other formats (i.e. large print). Contact HAP Midwest Member Services Department at (888) 654-0706 (TTY: 711) seven days a week, 8:00 a.m. to 8:00 p.m. Calls to these numbers are free.

Looking for a specific drug? There are two ways to find a drug:
  • You can search alphabetically (if you know how to spell the drug); or
  • You can search by medical condition.
To search alphabetically, go to the Alphabetical Listing section. The section provides an alphabetical list of all of the drugs included in this document. Both brand name drugs and generic drugs are listed in the Index. Look in the Index and find your drug. Next to your drug, you will see the page number where you can find coverage information. Turn to the page listed in the Index and find the name of your drug in the first column of the list.

To search by medical condition, find the section labeled “List of Drugs by Medical Condition”. Then find your medical condition. For example, if you have a heart condition, you should look in that category; that is where you will find drugs that treat heart conditions.

2016 HAP Midwest Health Plan Comprehensive Formulary
2017 HAP Midwest Health Plan Comprehensive Formulary
2018 HAP Midwest Health Plan Comprehensive Formulary

The HAP Midwest MI Health Link (Medicare-Medicaid Plan) has a transition policy to help you get your medications when you first become a member of our plan. We may cover a temporary 30-day supply of your drug during the first 90 days you are a member of HAP Midwest MI Health Link. This will give you time to talk to your doctor or other prescriber. He or she can help you decide if there is a similar drug on the Drug List you can take instead or whether to request an exception.

We will cover a 30-day supply of your drug if:
  • you are taking a drug that is not on our Drug List; or
  • health plan rules do not let you get the amount ordered by your prescriber; or
  • the drug requires prior approval by HAP Midwest MI Health Link; or
  • you are taking a drug that is part of a step therapy restriction.
If you live in a nursing home or other long-term care facility, you may refill your prescription for as long as 98 days. You may refill the drug multiple times during the 90 days. This gives your prescriber time to change your drugs to ones on the Drug List or ask for an exception. Exceptions are available in situations where you experience a change in the level of care you are receiving that also requires you to transition from one facility or treatment center to another. In such circumstances, you would be eligible for a temporary, one-time fill exception even if you are outside of the first 90 days as a member of the plan. For more information regarding the transition policy, see your member handbook.

For the most recent list of drugs, call Member Services at (888) 654-0706 (TTY: 711), seven days a week, 8 a.m. to 8 p.m. Calls to these numbers are free.

 

HAP Midwest MI Health Link
PO Box 2578
Detroit, MI 48202