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A formulary is a list of covered drugs. We select the drugs by working with a team of health care providers. The list contains the prescription medications we believe are a necessary part of a quality treatment program.

We generally cover the drugs listed in our formulary as long as:

  1. The drug is medically necessary
  2. The prescription is filled at a WellCare network pharmacy
  3. Other plan rules are followed.
Can the Formulary Change?

In general, if members are taking a drug on our 2017 formulary that was covered at the beginning of the year, we will not stop or reduce coverage of the drug during the 2017coverage year.

However, there are some cases when we may stop or reduce coverage. These are:

  • When a new, less expensive generic drug becomes available
  • When new negative information about the safety or effectiveness of a drug is released.

Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. For those members, it will remain available at the same cost share for the remainder of the coverage year. We think it’s important that members continue to get the formulary drugs that were available when they chose our plan for the remainder of the coverage year. The only exceptions are for cases in which they may save additional money or we can ensure their safety.

Use the links in this table to go to the formularies:

2018

Plans

Formulary ID

Plan Type

Formulary URL

PDP Plans Select

18443

Classic

http://client.formularynavigator.com/Search.aspx?siteCode=3119159574

PDP Plans
Extra

18439

Extra

http://client.formularynavigator.com/Search.aspx?siteCode=1417410309

PDP Plans Value Script

18442

Value Script - AZ, LA, OR, WA, WI

http://client.formularynavigator.com/Search.aspx?siteCode=1420391585

Essential - MAPD

18437

Choice, Plus, RX - IL only
Value - AR, CT, FL, IL, LA, KY, NJ, TN, TX
Essential, Preferred, Dividend, Dividend Prime - CT, FL, KY, MS, TN, TX
Access - CT, HI, LA, NJ, TX
Liberty - CT, HI, LA, NJ, TX

Premier and Guardian - FL only

http://client.formularynavigator.com/Search.aspx?siteCode=1423559190

Essential - MAPD

18437

Easy Choice Freedom - CA only

http://client.formularynavigator.com/Search.aspx?siteCode=1691273869


Essential - MAPD


18438

Choice, Essential, Preferred, Premier, Value - NY and CT
RX - CT only

http://client.formularynavigator.com/Search.aspx?siteCode=1696304771

5T Standard - MAPD

18435

Choice, Essential, and Value - GA, NC, SC, TN
Premier - GA and SC only
Prime - GA and SC only

http://client.formularynavigator.com/Search.aspx?siteCode=1698727057

Core with Supplemental (Viagra) on Tier 2

18436

Easy Choice Plus - CA only

http://client.formularynavigator.com/Search.aspx?siteCode=1701149344

Core with Supplemental (Viagra) on Tier 2 and additional gap coverage on Tier 1

18436

Easy Choice Best - CA only

http://client.formularynavigator.com/Search.aspx?siteCode=1703757960

Core with additional gap coverage on Tier 1

18436 Easy Choice Best - CA only

http://client.formularynavigator.com/Search.aspx?siteCode=1820116050
Generic Strategy Standard

18441
Access, Liberty, Select AR, FL, GA, KY, MS, NC, NY, SC, TN
RX - AR and TN only
Value - MS only

http://client.formularynavigator.com/Search.aspx?siteCode=1822724666
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Last Updated On: 9/20/2016
Based on a recent legal decision, changes to Medicaid under Kentucky HEALTH will not begin on July 1, 2018 as planned. Read more. Important Update about Kentucky HEALTH ×