MMP pharmacy benefits in Texas

Find a pharmacy

 

In most cases, you will need to use a pharmacy in our plan to get your prescription drugs. To find a pharmacy, view the Provider and Pharmacy Directories on the Find a Doctor page.

Don’t see your pharmacy listed in the directory?

Check your Member Handbook or call Pharmacy Member Services toll free at 833-232-1711 (TTY: 711) 24 hours a day, 7 days a week, to find out about out-of-network coverage.

Fill a prescription

 

Bring your member ID card and prescription to any pharmacy in our plan. You may need to pay the pharmacy a copay when you pick up your prescription. Check your Member Handbook to learn more about copays. You can also order and manage your prescriptions online by logging in to your account.

 

As a Medicare member, you may qualify for Extra Help with your Medicare prescription drug costs. To qualify for Extra Help, you must be receiving Medicare, have limited income, and live in one of the 50 states. Please visit the Social Security website for further information.

 

Get a long-term supply of a drug

 

For some drugs, you can get a long-term supply when you fill your prescription. A long-term supply is up to a 93-day supply. It costs you the same as a one-month supply.

 

The Provider and Pharmacy Directory tells you which pharmacies can give you a long-term supply of certain drugs. You may also be able to get a long-term supply through our mail order service.

 

Wellpoint STAR+PLUS MMP works with many pharmacies in your area to cover a wide range of brand-name and generic drugs.

 

Resources

Mail order prescriptions

 

You can get many prescription drugs shipped directly to your home through CarelonRx* Pharmacy, our mail-order delivery program for health plan members.

 

We make getting your prescriptions filled as convenient as possible. You can log in to your account and manage your prescriptions filled through home delivery. With your secure online account, you can:

 

 Order refills

 

 Track your shipments

 

 Get notifications

You can also contact your service coordinator, or call CarelonRx Pharmacy at 833-396-0309 (TTY: 711) or Pharmacy Member Services at 833-232-1711 (TTY: 711) 24 hours a day, 7 days a week, to get more information about filling your prescriptions by mail and/or participating in automated mail order. 

 

You can expect to get your drugs within 7 to 14 days of CarelonRx Pharmacy receiving the order. If your mail-order drugs do not arrive within 7 to 14 days, you should call CarelonRx Pharmacy at 833-396-0309 (TTY: 711) 24 hours a day, 7 days a week. The call is free.

 

* CarelonRx, Inc. is a separate company providing utilization review services on behalf of Wellpoint STAR+PLUS MMP (Medicare-Medicaid Plan).

See what drugs we cover

 

The Formulary (Drug List) is a list of all the brand-name and generic drugs available in your plan. To review the searchable Formulary, select the appropriate Formulary version from this menu:

 

2024 List of Covered Drugs (Formulary) – Updated as of 06/01/2024

 

Notice of Formulary Changes 

 

2024 List of Covered Drugs (Formulary) (English) 

 

2024 List of Covered Drugs (Formulary) (Spanish) 

 

If you would like a printed version of the Formulary, call Member Services or email the following information to DirectoryRequest_MMP@anthem.com:

 

 The name of the material you want to order (Formulary)

 

 Member name

 

 Member mailing address

 

 Member phone number

 

You can get the formulary for free in other formats, such as large print, braille, or audio. Call 855-878-1784 (TTY: 711) Monday through Friday from 8 a.m. to 8 p.m. local time. The call is free.

 

When calling, let us know if you want this to be a standing order. That means we will send the same documents in your requested format and language every year. You can also call us to change or cancel a standing order.

 

Don’t see your medication on the drug list?

 

We can help. Visit our Pharmacy Transition Plan  page to learn more.

Medication Therapy Management (MTM)

 

The Medication Therapy Management (MTM) program is a service for members with multiple health conditions and who take multiple medicines. The MTM program helps you and your doctor make sure your medicines are working together to improve your health. Visit our Medication Therapy Management page to learn more.