Simply Prescriptions Print Materials Requests

Simply Prescriptions Printed Materials

If you would like a Simply Prescriptions Drug Formulary or Provider Directory mailed to you, please complete the form below. For additional assistance, please call Customer Care at 1-877-883-9577 (TTY 1-800-662-1220) Monday - Friday, 8:00 a.m. - 8:00 p.m. Representatives are also available 8:00 a.m. - 8:00 p.m., Monday - Sunday, from October 1 - March 31.

Subscriber ID

First Name

Last Name

Street Address

Street Address 2

City

State

Zip Code

Email Address

Please select any/all desired materials:

Simply Prescription Drug Formulary 2024

Simply Prescription Drug Formulary 2023

Simply Prescription Provider Dir 2024

Simply Prescription Provider Dir 2023

Complete Request

Simply Prescriptions contracts with the Federal Government and is a PDP plan with a Medicare contract. Enrollment in Simply Prescriptions depends on contract renewal. Submit feedback about your Medicare presciption drug plan at www.Medicare.gov or by contacting the Medicare Ombudsman.

This page last updated 11/15/2021