Member Resources
2024 Formularies

2024 Prescription Drug Information (Part D)

PrimeTime Health Plan formulary 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.

The PrimeTime Health Plan Formulary is subject to change during the year. Most of the changes in drug coverage happen at the beginning of each year (January 1); however, the plan may make changes during the year, with CMS approval. In cases of any changes to our formulary including addition of a prior authorization, adding quantity limits, step therapy, making a drug non-formulary and changing cost share due to a tier level change of formulary drugs, PrimeTime Health Plan will send a letter to the members that have been affected by the change.

If one of your drugs is not covered in the way you would like it to be covered, you have the right to ask for a “coverage determination”. A coverage determination is when we make a decision about whether a drug is covered by the plan and the amount, if any, you are required to pay for the prescription.

When you ask for an exception, your doctor or other prescriber will need to explain the medical reasons why you need the exception approved. We will then consider your request. (You cannot ask for coverage of any “excluded drugs” or other non-Part D drugs which Medicare does not cover).

You, your representative, or your doctor (or other prescriber) can request a coverage determination by calling, emailing, writing, or faxing our plan. In addition, you may contact us for the most recent list of covered drugs or visit


For more detailed information, please refer to the “Coverage Determination” link on the Additional Information Page or your Plan's Evidence of Coverage.

Step Therapy Criteria - 7/1/24

Prior Authorization Criteria - 7/1/24

You, your representative, or your doctor (or another prescriber) can request a coverage determination by calling, emailing, writing, or faxing our plan:

Telephone: 330-363-7407 or toll-free 1-800-577-5084 (TTY Line: 711) Monday through Friday, 8:00 a.m. to 8:00 p.m. (October 1st – March 31st, we are available 7 days a week, 8:00 a.m. to 8:00 p.m.)


Fax: 330-580-6764

Mail: P.O. Box 6905, Canton, Ohio 44706

Enrollment Forms and Additional Information

HMO-POS Enrollment Form

Electronic Funds Transfer (EFT) Form


The top rating possible for 2024!

Get 5-star treatment with PrimeTime Health Plan. Every year Medicare rates plans, with the number of stars showing how well a plan performs based on member feedback and data from members, doctors, and hospitals. For 2024, the Centers for Medicare and Medicaid Services (CMS) awarded PrimeTime Health Plan a 5-star rating.

As CMS puts it, “More stars mean a better plan — for example, members may get better care and better, faster customer service.

2024 Star Rating icon 3 years in a row white box
Badge Medicare Advantage 2024 OHIO OL

U.S. News & World Report also analyzed plans in each state and rated PrimeTime one of the Best Insurance Companies for Medicare Advantage and prescription drug coverage in the entire nation for 2024.

With four plans, you have plenty of choices!

2024 Plan Overview and Comparison

PrimeTime Health Plan has a number of plan designs from which to choose. Our goal is to provide you with an affordable health plan to enhance your Medicare coverage.
PrimeTime Health Plan Basic MA – Only

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PrimeTime Health Plan Aultimate

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PrimeTime Health Plan Classic

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PrimeTime Health Plan Plus

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Learn More from Our Local Specialists.

We are here to help you.

  • Call us at 330-363-7407 (TTY 711) from 8 a.m. to 8 p.m., Monday through Friday. Talk to a local specialist or schedule a 1-on-1 meeting to discuss your options. 
  • Join us for a free informational webinar to ask questions and learn more about PrimeTime Health Plan's Medicare Advantage plans. 

Contact Us 

Trisha PrimeTime Health Plan Team Member
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