Formulary Search
A comprehensive formulary is the entire list of drugs covered by HealthSun and is posted above for your review or download.
HealthSun covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. View Availability Grid Below.
- Our plan covers most Part D vaccines at no cost to you. Call Member Services for more information.
- You won't pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it's on.
To see if your prescription is covered by our plan, please type in the name of the drug below:
| Drug Name | Strength | Drug Tier | Generic or Brand | Quantity / Days | Availability | Category |
|---|---|---|---|---|---|---|
| No results | ||||||
A formulary is a list of drugs covered by your plan to meet patient needs.
If your drug is not included in this formulary, you should first contact Member Services and confirm that your drug is not covered. If you learn that HealthSun does not cover your drug, you have two options:
You can ask Member Services for a list of similar drugs that are covered by HealthSun. When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that is covered by HealthSun.
You can ask HealthSun to cover a drug by Requesting an Exception
| Symbol | Name | Abbreviation Description |
|---|---|---|
| 90D | 90 Day Benefit | This drug is approved for a 90-day supply. |
| 100D | 100 Day Benefit | This drug is approved for a 100-day supply. |
| B/D PA | Part B vs. Part D Prior Authorization Review | This drug may be covered under Medicare Part B or Medicare Part D depending upon the circumstances. |
| ED | Enhanced Drug Coverage | Coverage for excluded Medicare Part D Drugs. This prescription drug is not normally covered in a Medicare Prescription Drug Plan. The amount you pay when you fill in a prescription for this drug does not count towards your total drug costs (that is, the amount you pay does not help you qualify for catastrophic coverage). In addition, if you are receiving extra help to pay for your prescriptions, you will not get any extra help to pay for this drug. |
| HRM | High Risk Medication | PA required for ages 65 or over. |
| NEDS | Non-Extended Days Supply | This drug is approved for no more than a 30-day supply. |
| MO | Mail-Order | This drug is available at our mail order pharmacies. |
| PA | Prior Authorization | You (or your physician) are required to get prior authorization before you fill in your prescription for this drug; without prior approval, we may not cover this drug. |
| QL | Quantity Limit | There is a limit on the amount of this drug that is covered per prescription, or within a specific timeframe. Certain drugs marked “QL” for quantity limit will indicate the amount (days’ supply or amount dispensed). |
| ST | Step Therapy | In some cases, you may be required to first try certain drugs to treat your medical condition before we will cover another drug for that condition. |
| Tier | Drug Tier Name |
| 1 | Preferred Generic |
| 2 | Generic |
| 3 | Preferred Brand |
| 4 | Non-Preferred Drug |
| 5 | Specialty Tier |
| 6 | Supplemental Drugs - (enhanced drug coverage) |
Have questions? We’re here for you.
Call: 1.877.336.2069 TTY: 711 or write: info@healthsun.com
For more options and for hours of operation, visit our Contact page
HealthSun Health Plans is an HMO D-SNP plan with a Medicare Contract and a Medicaid contract with the State of Florida Agency for Health Care Administration. Enrollment in HealthSun Health Plans depends on contract renewal. We do not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, sex, age, or disability in our health programs and activities. Hablamos español y podemos ayudarle a encontrar el plan ideal para usted. If you speak a language other than English, translation and alternate format services are available to you on a standing basis, free of charge. Just call 1-877-336-2069 (TTY: 711), 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas) from October 1 through March 31, and Monday to Friday (except holidays) from April 1 through September 30.
Do you need to file a complaint? File your complaint online via CMS by submitting the Medicare Complaint Form. Should you need to file a complaint with Medicare you may do so by calling CMS at 1-800-Medicare.
You can report suspected fraud or any other non-compliance activity by calling our Member Services Department at 877-336-2069 or TTY at 877-206-0500.
Y0114_26_3018333_0000_U_M 10/01/2025