With the new year we changed Medicare part D Prescription Drug Plan. My doc called in a prescription to CVS and by their on line formulary there was no prior authorization needed from Mutual of Omaha. It should have been $2.00 charge at CVS. However, when i got there it was $16 and CVS said M of O wouldn't cover it. Called M of O and was told doc did not get prior authorization so they didn't pay, I looked up formulary and no PA was noted with Tramadol. Was told by rep that THEIR formulary had PA needed so that was what controlled. I asked rep to go on line and look at the formulary customers go by. She wouldn't do it. so, they get away with paying nothing on what is a legitimate prescription according to M of O on line formulary. Whats to make things worse is that you dont get to talk to a M of O employee. Express Scrips is the company you talk to as they manage the drug plan. Their answer to this entire problem is to call into Express Scrips on each one of your prescriptions and double check on the Tier its in as well as if prior authorization is needed. I did talk with a lady named Mercedes who was nice and very helpful. She understood but this problem was way beyond her pay grade. User's recommendation: Be very careful when buying and ask a lot of questions. Their secret formulary is what controls.mulary.