Yes! Many Medicare drug plans have what’s called a coverage gap (sometimes known as “the donut hole”). This means that after you and your drug plan have spent a certain amount of money for covered drugs, you could have to pay more for your prescription drugs (up to a certain limit).

 Your Total plan provides coverage of medications through all phases, including the gap. Since Total members are full subsidy beneficiaries, you will have no additional cost shares during the gap. You will always have $0 cost share.

The Medication Therapy Management program is a service designed for members who have several chronic medical conditions or take many different drugs at the same time.

Learn more about the Medication Therapy Management program.

As a rule, you must use a network pharmacy. If you think you can’t get to a network pharmacy, please call us. We may be able to find one for you nearby. Be aware that you may need to pay for the items out of pocket and be reimbursed.

There may be a rare instance when you need a medication and cannot get to a network pharmacy. Please see Chapter 5 (“Using the plan’s coverage for your Part D prescription drugs”) in your Evidence of Coverage/Member Handbook for situations when we would cover prescriptions filled at an out-of-network pharmacy.

It’s easy to find a participating pharmacy. Use the Provider and Pharmacy Search tool on this website. If you are unable to find a pharmacy using this tool, please call us, and we will help you.

Yes, you can. If you take multiple pills each day, you can keep track of your doses with a pill pack. Pills are organized by day and time, so you know which to take when. If this sounds like a good way to keep track of your doses, call us. Our pharmacists can connect you with local pharmacies that can put these packs together for you at no charge.

Yes, you can. As a member of VNS Health Total, your pharmacy benefit is managed by MedImpact. Their mail-order service, Birdi, can fill prescriptions and mail them to your home.

Here are three ways to sign up for the Birdi mail-order service from MedImpact:

1. Register online at medimpact.com.
2. Register with the MedImpact mobile app.
3. Call Birdi toll free at 1-855-873-8739 (TTY: 711), Monday–Friday, 8 am–8pm and Saturday, 9 am–5 pm.