Magellan Rx Medicare

Magellan Rx Management is a mission-driven pharmacy benefit management organization with a boundless desire to help others. We are an engaged partner that listens to your needs and delivers valuable solutions across the constantly evolving healthcare landscape.

Magellan Rx Medicare Program Support

The Magellan Rx Medicare Center of Excellence was developed to help provide exceptional member-centric service by empowering our dedicated team to achieve our mission with integrity, compassion, accuracy, respect, and enthusiasm. Our Medicare program is designed to improve the member experience, promote safety, and effectively manage costs.


medicare | Magellan Rx Management

Regulatory Guidance
Committed to meeting or exceeding regulatory requirements. Our track record speaks for itself.
• Compliance Audit Support
• Government Relations
• CMS Requirements
• Government Relations


plan support | Magellan Rx ManagementPlan Support
Everything starts and ends with the beneficiary. If you look good, we look good.
• Network Management
• Grievance
• Customer Care Center
• Reporting
• Marketing and Correspondence


clinical support | magellan rx managementClinical Support
Program support to assist the beneficiaries in receiving the right drug at the right time.
• Medication Therapy Management (MTM)
• Star Ratings/HEDIS Quality Program
• P&T/Formulary Development
• Utilization Management


Magellan Rx’s Culture of Compliance

Our Compliance Program is overseen and operated by individuals with extensive Medicare, CMS, and regulatory audit experience and established relationships with CMS. We are keenly focused on the full scope of compliance requirements, including:

  • Policies, Procedures & Standards of Conduct
  • Compliance Officer, Compliance Committee
  • Training & Education
  •  Prompt Response to Compliance Issues
  •  Lines of Communication
  • Fraud, Waste & Abuse
  • Well-Publicized Disciplinary Standards
  • Routine Monitoring & Auditing

Perfect Audit Score

Magellan Rx received a perfect audit score from the Centers for Medicare & Medicaid Services (CMS) for its Granite Alliance Insurance Company Employer Group Waiver Plan (EGWP), a type of Medicare Prescription Drug (Part D) plan.* The program audit was conducted in September 2021 and tested three main areas of the program:

  1. Compliance Program Effectiveness (CPE)
  2. Formulary and Benefit Administration (FA)
  3. Coverage Determinations, Appeals, and Grievances (CDAG)

Awards and Recognition

Our Magellan Rx Medicare products are industry leading and we have been recognized by our peers for plan and beneficiary support!

  • 6th consecutive year earning 5-Star member satisfaction rating
  • Pharmacy Quality Alliance (PQA) Laura Cranston Quality Improvement Award over all PDP and EGWPs nationwide

Want to learn more about Magellan Rx Medicare? Connect with us!

Get in touch with our experts to learn more about the Magellan Rx Medicare programs.

OUR MISSION

is to be a trusted partner in delivering high-quality Medicare services to meet the unique needs of all beneficiaries.

*Past performance does not guarantee future results.