Medication Coverage

Rich Media

Important News: The New York State Department of Health ended the Fully Integrated Duals Advantage (FIDA) program on Dec. 31, 2019. FIDA plans are not accepting any new enrollees or plan transfers in 2020. 

How can I find out if a certain medication is covered by VNSNY CHOICE FIDA Complete (Medicare-Medicaid Plan)?

CHOICE FIDA Complete covers a broad range of drugs for hundreds of ailments and conditions. This includes both brand name drugs and generics. To find out if a specific drug is covered, you can use this link to the List of Covered Drugs (Formulary) Search. Or, you can look in the List of Covered Drugs booklet you received when you enrolled.  
Some drugs have coverage rules or have limits on the amount you can get. In some cases you must do something before you can get the drug. See the Frequently Asked Questions in your List of Covered Drugs (Formulary) for more information. 
How do I find a pharmacy that’s part of the VNSNY CHOICE FIDA Complete network? 
It's easy to find a participating pharmacy.
Do I have to use a network pharmacy for medications and supplies? 
Yes, plan participants must use network pharmacies to access their prescription drug benefit, except in emergency and urgent care situations. If you go to an out-of-network pharmacy for prescriptions when it is not an emergency, you will have to pay out of pocket for the service. Please see your Participant Handbook/Evidence of Coverage for the situations when CHOICE would cover prescriptions filled at an out-of-network pharmacy.

VNSNY CHOICE FIDA Complete is a managed care plan that contracts with both Medicare and the New York State Department of Health (Medicaid) to provide benefits of both programs to Participants through the Fully Integrated Duals Advantage (FIDA) Demonstration.

The State of New York has created a Participant Ombudsman Program called the Independent Consumer Advocacy Network (ICAN) to provide Participants free, confidential assistance on any services offered by VNSNY CHOICE FIDA Complete. ICAN may be reached toll-free at 1-844-614-8800 or online at (TTY users call 711, then follow the prompts to dial 844-614-8800.)

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-783-1444 (TTY: 711).

You can get this information for free in other formats, such as Braille or audio CD. Call 1-866-783-1444 (TYY: 711) during 8 am – 8 pm, 7 days a week. The call is free.

Last updated 1/2/2020


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