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Medication Guide

What is a formulary?
A formulary is a list of drugs covered by WellCare. We work with health care providers to create our formulary, which also includes prescription therapies believed to be a necessary part of a quality treatment program. WellCare will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a WellCare network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

Both the formulary search tool and downloadable formulary will provide you with drug details and formulary alternatives that may help lower your drug costs. If you have questions about our formulary, or if your medication is not listed, please use the Contact Us form.

What is a comprehensive formulary? 
A comprehensive formulary is a list of drugs covered by WellCare and is posted for you to review. 

Can the formulary change? 
The formulary may change during the year. To get updated information about the drugs covered by WellCare, please see the most recently posted formulary on this website or call Customer Service.
                
What are generic drugs? 
WellCare 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. 

For other descriptions of prescription drug terms, view our glossary of terms.

You can also see an archive of Past Formularies

How can I save money with WellCare?

  • Fill your prescription through CVS/Caremark mail-service pharmacy.

You can fill your prescription at any WellCare network pharmacy. However, if you fill your prescription through CVS/Caremark mail-service pharmacy that offers preferred cost-sharing, you could pay less. Visit the Medicare section of the Help Center and see "How do I start receiving my prescriptions through mail service delivery?" to learn more.

  • Switch to our preferred generic drugs

Ask your doctor if any of your drugs are available as a generic, and if the generic version would work for you. Generic medications are FDA-approved and have the same active ingredients, indicators, dosages, safety and strengths as the brand name medications and generally cost less.

Quantity Limits 
For certain drugs, the drug amount WellCare will cover is limited. Drugs with quantity limits are noted with "QL" on the downloadable formulary and in search tool. 

Documents

WellCare requires you or your physician to obtain prior authorization for certain drugs. This means you will need approval from WellCare before you fill your prescriptions. If you do not get approval, WellCare may not cover the drug. Drugs that require prior authorization are noted with "PA" on both the downloadable formulary and search tool.

In some cases, WellCare requires you first try specific drugs to treat your medical condition before we will cover another drug for that condition. Drugs that require step therapy are noted with "ST" on both the downloadable formulary and search tool.

You can also see an Archive of Past Formularies


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Y0070_WCM_06390E CMS Approved 10/23/2017 Last Updated On: 10/1/2017
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