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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.

Access the Formularies

2016
2017

Can the Formulary Change?

In general, if members are taking a drug on our 2016 formulary that was covered at the beginning of the year, we will not stop or reduce coverage of the drug during the 2016 coverage 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:

2016

Plans

Formulary ID

Plan Type

Formulary URL

PDP Plans

16187

Classic

Extra

Simple

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

Georgia Plans

16188

Essential Value

https://client.formularynavigator.com/Search.aspx?siteCode=1693696155

California Plans

16187

Freedom

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

California Plans

16186

Best

Value

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

California Plans

16186

Plus

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

California Plans

16186

Best

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

All Other Plans

16187

Access

Choice

Dividend

Essential

Liberty

Reserve

Rx

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

NY FIDA MMP

16064

Advocate Complete

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


2017

Plans

Formulary ID

Plan Type

Formulary URL

PDP Plans
Select


AZ, CA, CO, FL, IA, IL, KS, MN, MT, NC, ND, NE, NJ, NM, NV, SC, SD, TX, VA, WY

17291

Classic

http://client.formularynavigator.com/Search.aspx?siteCode=1549000204

PDP Plans
Essential


AK, AL, AR, CT, DC, DE, GA, HI, ID, IN, KY, LA, MA, MD, ME, MI, MO, MS, NH, NY, OH, OK, OR, PA, RI, TN, UT, VT, WA, WI, WV

17292

Classic/Extra

http://client.formularynavigator.com/Search.aspx?siteCode=1552726799

Essential Formulary with Supplemental on Tier 2


17293

Freedom

http://client.formularynavigator.com/Search.aspx?siteCode=1555149085


CCP Plans

AR, CT, FL, IL, KY, LA, MS, NJ, NY, TN, TX

17293

Access
Choice
Dividend
Essential
Liberty
Plus
Preferred
Rx
Value

http://client.formularynavigator.com/Search.aspx?siteCode=1557757701


CCP Plans

GA, SC

17295

Choice
Essential
Value


http://client.formularynavigator.com/Search.aspx?siteCode=3109284100


Expanded Performance with Supplemental on Tier 2


17296

Plus

http://client.formularynavigator.com/Search.aspx?siteCode=3111706386


Expanded Performance with Supplemental on Tier 2 and Additional Coverage Gap on Tier 1

17296

Best 005

http://client.formularynavigator.com/Search.aspx?siteCode=3114128672


Expanded Performance with Additional Coverage Gap on Tier 1

17296

Best 016

http://client.formularynavigator.com/Search.aspx?siteCode=3116737288


CCP Plans

AR, FL, GA, HI, KY, MS, NY, SC, TN

17297

Access
Liberty
Reserve
Rx
Select
Value

http://client.formularynavigator.com/Search.aspx?siteCode=0619530736




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Last Updated On: 10/19/2016
Update on Heritage Health Member ID Cards WellCare has sent ID cards to members in the Heritage Health Nebraska plan. These ID cards should arrive soon, but if you have not received your ID card and need immediate care, please contact customer service at 1-855-599-3811 for assistance. ×