HealthChoice Medicare Supplement Plans
Notice Regarding Formulary Changes

Most formulary changes occur at the beginning of each plan year; however, sometimes formulary changes occur midyear. HealthChoice may:

• Add or remove a drug from the formulary
• Add or remove a coverage restriction
• Replace a brand-name drug with a generic
• Move a drug to a higher or lower tier

If a drug you take is affected by a change, HealthChoice is required to notify you at least 60 days before the change, or at the time you request a refill. If you receive notice of a formulary change, work with your physician to switch your prescription to a covered drug. Depending on the type of change, you may be able to request a prior authorization and ask HealthChoice to continue to cover the drug for you.

If the Food and Drug Administration finds a drug is unsafe or a drug is removed from the market, HealthChoice will immediately remove the drug from our formulary and then notify you of the change. Your doctor will also know about this change and can prescribe another drug for your condition.

For more information, please contact Express Scripts, 24 hours a day, 7 days a week, at:

With Part D call toll-free 1-800-590-6828 or toll-free TDD 1-800-716-3231
Without Part D call toll-free 1-800-903-8113 or toll-free TDD 1-800-825-1230