List of Drugs (Formulary)

Our list of drugs (formulary) shows the Part D drugs that we cover. In general, we cover your drugs if they are medically necessary. Drugs on our list of drugs are covered when you use our network pharmacies or preferred mail order service for maintenance drugs. Maintenance drugs are drugs you take for a chronic or long-term condition. Some drugs we cover have limits or other rules.

The Pharmacy and Therapeutics Committee, our team of independent healthcare experts, reviews and approves our list of drugs. We don’t include all drugs. Some drugs may not be covered or are excluded. Other drugs are not on the list because of clinical and cost reasons.

How Do I Search for a Drug in the List of Drugs (Formulary)?

You can search for a drug by using our Drug Search Tool or by opening the List of Drugs (Formulary) PDF document. Each option gives you a complete list of covered drugs and any restrictions or limits. The search tool also shows you covered drug alternatives.

The PDF document lists drugs by medical condition and alphabetically within the index. To search for your drug in the PDF, hold down the “Control” (Ctrl) and “F” keys. When the search box appears, type the name of your drug. Press the “Enter” key. You also have the option to print the drug list as a PDF document. The drug list is updated monthly.

Updated September 3, 2024:

List of Drugs Change Notice

Drugs may be added or removed from our list of drugs during the year. Generally, we will tell you before we make one of the following changes to the list of drugs:

If the Food and Drug Administration (FDA) or the drug’s maker says a drug is not safe, it will be removed from our list of drugs right away. In addition, if a new generic drug comes to market, we may remove the brand name drug. To view the changes, open the List of Drug Change Notice PDF document below.

List of Drugs Change Notice: February 1, 2024

Drug Coverage Determinations

You can ask us to make an exception to our coverage rules for your drug(s). To learn about the types of exceptions, refer to your Evidence of Coverage. When asking for an exception, include a statement from your doctor that supports your request, plus a completed Coverage Determination form.

Generally, we must decide on your request within 72 hours after we get your doctor’s statement. You or your doctor can request a fast (expedited) exception if your health may be harmed by waiting. If we approve your expedited request, we must give you a decision within 24 hours after we get your doctor’s supporting statement.

Generic Drugs

We cover both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug.

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

Mail Order Service

You can fill your prescription at any network pharmacy. You also can fill your prescription through our preferred mail order service—Express Scripts® Pharmacy. You can find more information about receiving your prescriptions through mail service delivery on our Mail Order Service page.

If you have questions about our list of drugs, or want the most recent version, contact Member Services. We are here to help.

List of Drugs (Formulary)

Our list of drugs (formulary) shows the Part D drugs that we cover. In general, we cover your drugs if they are medically necessary. Drugs on our list of drugs are covered when you use our network pharmacies or preferred mail order service for maintenance drugs. Maintenance drugs are drugs you take for a chronic or long-term condition. Some drugs we cover have limits or other rules.

The Pharmacy and Therapeutics Committee, our team of independent healthcare experts, reviews and approves our list of drugs. We don’t include all drugs. Some drugs may not be covered or are excluded. Other drugs are not on the list because of clinical and cost reasons.

How Do I Search for a Drug in the List of Drugs (Formulary)?

You can search for a drug by using our Drug Search Tool or by opening the List of Drugs (Formulary) PDF document. Each option gives you a complete list of covered drugs and any restrictions or limits. The search tool also shows you covered drug alternatives.

The PDF document lists drugs by medical condition and alphabetically within the index. To search for your drug in the PDF, hold down the “Control” (Ctrl) and “F” keys. When the search box appears, type the name of your drug. Press the “Enter” key. You also have the option to print the drug list as a PDF document. The drug list is updated monthly.

Updated October 1, 2024:

List of Drugs Search Tools and Documents:

Select your plan to find your drug list, search tools, and documents.

Wellcare Dual Liberty (HMO D-SNP)

List of Drugs Search Tool

List of Drugs Documents

Drug Change Notice Document

Wellcare Dual Align (HMO D-SNP)

List of Drugs Search Tool

List of Drugs Documents

Drug Change Notice Document

TBD (HMO C-SNP)

List of Drugs Search Tool

List of Drugs Documents

Drug Change Notice Document

TBD (HMO MAPD)

List of Drugs Search Tool

List of Drugs Documents

Drug Change Notice Document

List of Drugs – Group A:

List of Drugs – Group C:

List of Drugs – Group E:

List of Drugs – Group B:

List of Drugs – Group D:

List of Drugs – Group F:

Alternative Drug List

Are you currently taking a drug that is not covered on your plan’s List of Drugs (formulary)? The form below is a partial list of the drugs that are not covered, along with their covered alternative drugs. Talk to your provider to see if the drug alternatives listed in the PDF form below will work for you.

Alternative Drug List - English (PDF) – last updated 10/1/2024

You can ask us to make an exception to our rules for your drug(s). To learn how, read your Evidence of Coverage. When asking for an exception, include a statement from your doctor that supports your request, plus a completed Coverage Determination form.

Generally, we must decide on your request within 72 hours after we get your doctor’s statement. You can ask for a fast (expedited) exception if you or your doctor believe that your health could be seriously harmed by waiting up to 72 hours. If we approve your expedited request, we must give you a decision within 24 hours after we get your doctor’s statement.

List of Drugs Change Notice

Drugs may be added or removed from our list of drugs during the year. Generally, we will tell you before the following changes are made to the list of drugs:

If the Food and Drug Administration (FDA) or the drug’s maker says a drug is not safe, it will be removed from our list of drugs right away. In addition, if a new generic drug comes to market, we may remove the brand name drug.

List of Drugs Change Notice (PDF) – coming February 2025.

List of Drugs Change Notice: February 1, 2024

Drug Coverage Determinations

You can ask us to make an exception to our rules for your drug(s). To learn about the types of exceptions, refer to your Evidence of Coverage. When asking for an exception, include a statement from your doctor that supports your request, plus a completed Coverage Determination form.

Generally, we must decide on your request within 72 hours after we get your doctor’s statement. You or your doctor can request a fast (expedited) exception if your health may be harmed by waiting. If we approve your expedited request, we must give you a decision within 24 hours after we get your doctor’s supporting statement.

Generic Drugs

We cover both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs are FDA-approved and are as safe and effective as brand name drugs. They have the same active ingredients, indications, dosages, safety, and strengths as the brand name drugs and generally cost less. Ask your doctor if any of your drugs are available as a generic, and if a generic version will work for you.

Mail Order Service

You can fill your prescription at any network pharmacy. You also can fill your prescription through our preferred mail order service—Express Scripts® Pharmacy. You can find more information about receiving your prescriptions through mail service delivery on our Mail Order Service page.

If you have questions about our list of drugs, or want the most recent version, contact Member Services. We are here to help.

Wellcare by Allwell from Arizona Complete Health
7700 Forsyth Boulevard
Clayton, MO 63105

D-SNP 1-844-796-6811 (TTY: 711)
HMO /C-SNP 1-800-977-7522 (TTY: 711)

© Copyright 2024 Centene Corporation. All Rights Reserved.

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Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

Arizona D-SNP plans: Contract services are funded in part

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

Arizona D-SNP plans: Contract services are funded in part under contract with the State of Arizona.

Every year, Medicare evaluates plans based on a 5-star rating system.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

Please contact your plan for details.

Updated date: 10/1/2023

Material ID: Y0020_22_WEBALLWELL_M_2024