A Healthy CollaborationSM

Out-of-Network Coverage

Pharmacy Out-of-Network Coverage*
Today’s Options has formed a network of pharmacies. You must use a network pharmacy to receive plan benefits. We will not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases. The pharmacies in our network can change at any time. You can use our Pharmacy Locator, or call Member Services for an up-to-date list.

Formulary medicines may be covered in special circumstances, such as illness while traveling outside of the plan’s service area where there is no network pharmacy. You may pay more than the co-pay if you get your drugs at an out-of-network pharmacy.

For limits and your financial responsibility for access to drugs at out-of-network pharmacies, please see your Summary of Benefits.

*Applies only to Medicare beneficiaries enrolled in plans with Medicare Part D Prescription Drug Coverage.

Medical Out of Network Coverage
With a Today’s Options Medicare Advantage Private Fee-for-Service Plan, you’re not locked into a defined network of doctors and hospitals. You have the freedom to choose any doctor in your service area that participates in Medicare and accept the Today’s Options’ terms and conditions. You are not required to get pre-approved before obtaining services. However, notification is requested prior to or within 48 hours of planned Inpatient Hospital Care, Inpatient Mental Healthcare, Outpatient Services/Surgery, Durable Medical Equipment, and Prosthetic Devices. Please refer to your Summary of Benefits or Evidence of Coverage document if you are not sure.

M0018_PFFSWebv5_0209 Pending CMS Approval Last updated: 4/1/2022

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