The VillageHealth formulary is a continually updated list of prescription medications covered by VillageHealth The VillageHealth Formulary is developed by the VillageHealth Pharmacy and Therapeutics Committee to ensure that included drugs are safe, effective, FDA approved and appropriate. The committee is comprised of physicians and pharmacists, many of whom have clinical expertise in End Stage Renal Disease (ESRD). The formulary contains both brand and generic drugs.

VillageHealth covers both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

The Medicare program allows us to make changes in our prescription drug formulary list at any time during the calendar year. As previously explained, the formulary is a list of drugs. A change in our drug formulary could affect which drugs are covered, the members co pay and the limit on usage.

Members who have limited income and resources that need help with paying for their prescription drugs may be able to receive extra help through the Medicare Part D Low Income Subsidy program. Please call Member Services at 1-877-586-1648, 7:00 a.m. – 8:00 p.m, 7 days a week. TTY users should call 1-866-525-7833.

To see if you qualify for getting Extra Help, call:

• 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, 7 days a week.
• The Social Security Office at 1-800-772-1213, between 7 am to 7 pm, Monday through Friday. TTY users should call 1-800-325-0778; or
• Your State Medicaid Office. (See Chapter 2 Section 6 of the Evidence of Coverage for contact information. The Evidence of Coverage can be found under the Links to Important VillageHealth Information section of the website.)

Use this search function to determine if a medication is covered under the VillageHealth pharmacy benefit.

Find a drug by selecting any of the following options for locating the medication you are looking for. You may select one of the methods to find a particular medication.


To download the 2012 transition policy in English Spanish Chinese Vietnamese , click here.

You will need Adobe Acrobat Reader to view this document.

Click here to get Adobe Acrobat

Best Available Evidence Policy