Skip to main content
MyBlue®:

FEP Medicare Prescription Drug Program (MPDP)

New for 2024: A Medicare prescription drug benefit for eligible members who qualify for Medicare Part A and/or Medicare Part B utilizing Medicare as their Primary Health Care coverage.

Resources to help you learn more

See how the FEP Medicare Prescription Drug Program can help you save on the prescriptions you need. Download our guide to learn more.

Download Guide

MPDP Resources

Evidence of Coverage (EOC)

View instructions on how to get your prescriptions drugs, your rights and responsibilities and more.

 

Basic Option EOC

Standard Option EOC

 

Order a printed copy

MPDP Pharmacy Directory

View the network of pharmacies where you can fill your prescriptions.

 

MPDP Pharmacy Directory

MPDP Formularies

View the approved drug list under the MPDP drug tiers.

 

 

FEP Blue Focus MPDP Drug List

Basic Option MPDP Drug List

Standard Option MPDP Drug List

 

Order a printed copy

IRMAA

View information about Income-Related Monthly Adjustment Amount (IRMAA).

 

Visit medicare.gov

Additional MPDP Materials

Prescription Drug Transition Policy

Coming Soon

Annual Notice of Change

Coming Soon

Prior Approval Criteria

Some medications require prior approval before coverage is provided. You can view a list for each plan below.

FEP Blue Focus MPDP Criteria 

Basic Option MPDP Criteria

Standard Option MPDP Criteria

 

Step Therapy Criteria

Some medications may require a previous use of one or more drugs before coverage is provided. You can view a list for each plan below.

FEP Blue Focus MPDP Step Criteria 

Basic Option MPDP Step Criteria

Standard Option MPDP Step Criteria

 

Enhanced Prior Approval Criteria

Additional drug coverage under this enhanced benefit may require prior approval before coverage is provided. View the list below for more information.

Enhanced Prior Approval Criteria

 

Utilization Management Forms

Coming Soon

Part D Model Coverage Determination and Redetermination Request Forms

Coming Soon

Appeal Request

If we have denied coverage or payment for a drug under your Medicare Part D benefit and you do not agree with our decision, you have the right to appeal the decision. View the document below for more information.

CMS Appointment of Representative Form (CMS Form-1696)

If you’re in MPDP and would like to appoint a person to file a grievance, request a coverage determination or request an appeal on your behalf, you and the person accepting the appointment must fill out this form and submit it with your request. Your prescribing physician or other prescriber may request a coverage determination, redetermination or IRE reconsideration on your behalf without having to be an appointed representative.

To file a complaint directly with Medicare, you can call 1-800-MEDICARE or submit an online form.

If you’re a member of MPDP or a physician and have questions about process or status, you can call 1-800-MEDICARE.

To view a Notice of Privacy Practices as required under the HIPAA Privacy Rule (45 CFR 164.520) click here.

MPDP FAQs

We know you may have questions about our new prescription drug benefit. Here we address your most common questions.

General

Prescription Drugs

Mail Service Pharmacy