At Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO), you can obtain your prescription drugs through a pharmacy drug benefit (Medicare Part D) or a medical drug benefit (Medicare Parts A and B). On this page you will find information specific to the pharmacy drug benefit (Medicare Part D).
Our plan helps pay for many prescription drugs. To get covered drugs by Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO), you must:
You can get your covered drugs at:
Local pharmacies near you
Our mail-order pharmacy (medicine sent right to your home) which can be accessed through your member portal
Specialty Pharmacies
Always bring your Medicare Card and your Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO) member ID card to the pharmacy. Below are samples of what these cards look like:
Use our online Pharmacy Finder to find a pharmacy close to you that accepts our plan.
Click here to search our covered drug list.
If you have Extra Help program from Medicare, your drug costs might be lower or even $0. If you don’t have Extra Help, you may have copays or coinsurance for your medicines, but there are certain drugs that will be covered by Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO) for which you will pay $0. Visit SSA.gov/extrahelp to apply for Extra Help.
| Tier | Subject to the deductible | Coinsurance | Max Day Supply |
| Tier 1 (Preferred Generic) | No | 0% | 100 |
| Tier 2 (Generic) | Yes | 25% | 90 |
| Tier 3 (Preferred Brand) | Yes | 25% | 90 |
| Tier 4 (Non-Preferred Brand) | Yes | 25% | 90 |
| Tier 5 (Specialty) | Yes | 25% | 30 |
| Tier 6 (Select Care Drugs) | No | 0% | 100 |
When you first join Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO), you might need time to get used to your new medicines. Or if you are already enrolled with Health Plan of San Joaquin/Mountain Valley Health Plan Advantage D-SNP (HMO) and a change to the rules for your drug occurs, you may need time to talk to your doctor about your next steps. The Part D Transition process helps you keep getting your important prescription drugs right away, even if they are not on your new plan’s list or need special approval. This gives you time to talk with your doctor about your medicines and find the best plan for you. For more information, see Part D Transition Policy.
Medication Therapy Management (MTM) is a service that helps you get the most from your medicines. A pharmacist or healthcare provider will review all the medicines you take to make sure they are working well and are safe for you. Click here to learn more.
If you have trouble paying for your prescriptions all at once, ask about programs that can help pay for your medications.
Click here to learn more.
7751 S. Manthey Road French Camp, CA 95231
1-888-361-7526 (TTY: 711)
Hours of Operation: 8:00 a.m. – 8:00 p.m.
Mon – Sun: October 1 – March 31
Mon – Fri: April 1 – September 30
H5734_606099_2026
Posted on September 16th, 2025 and last modified on October 1st, 2025.
top