Search the Wellcare Medicare Drug Formulary
- Search the Wellcare Medicare drug formulary to find out if your prescriptions are covered by a Wellcare Medicare plan. You can also compare Wellcare Medicare Advantage Prescription Drug (MA-PD) plans online to find Wellcare Medicare drug coverage available where you live.
Wellcare Medicare Advantage (Medicare Part C) plans and Medicare Part D prescription drug plans (PDP) are two types of Medicare plans that can cover prescription drug costs.
Medicare beneficiaries can choose either a standalone PDP to go along with their Original Medicare (Parts A and B) coverage, or they can choose a Wellcare Medicare Advantage plan that covers all Part A and Part B benefits in one single plan and often include extra benefits like dental, hearing, vision and – importantly – prescription drugs.
As with nearly any Medicare plan that includes drug coverage, Wellcare Medicare plans come with a formulary, or list of medications that are covered by the plan.
Read below to learn more about Wellcare Medicare drug formularies. You can also compare plans online to find a Wellcare Medicare plan near you that covers your prescription drugs, or you can call to get help from a licensed insurance agent.
Search the Online Wellcare Formulary
You can search this 2022 Wellcare Medicare drug formulary for PDP plans in all states to see if your prescription drugs are covered, what tier they’re on (which affects how much your drugs cost) and where there are any requirements or limits for the drug.
Please note that drug coverage can change, and that the example formulary is specifically for the Wellcare Value Script (PDP) Part D plan. You may have other plan options – including Wellcare Medicare Advantage plans with drug coverage – that cover your prescription drugs.
Is Wellcare the Same as Part D?
Medicare Part D is a type of Medicare insurance that provides coverage for prescription medications. Part D is sold by private insurance companies. You can use a standalone Part D plan alongside your Original Medicare benefits, or you can add Part D coverage to a Medicare Advantage plan that doesn’t already include drug coverage.
Wellcare is one of the top insurance companies that sell Medicare Part D plans and Medicare Advantage plans.
What Drugs Are Included on a Wellcare Formulary?
Wellcare Medicare plan formularies feature a wide spectrum of drugs that include both generic and brand-name medications, ranging from low-cost and commonly prescribed drugs to high-cost rare and specialty drugs.
What If My Drug Is Not Listed in the Wellcare Formulary?
If a medication you take is not listed on the Wellcare formulary, you may be able to ask your doctor for a prescription for a similar drug that is included on the formulary. Or you may find coverage for your medication in a different Wellcare plan or a plan offered by another carrier.
How Does a Wellcare Formulary Work?
As with most insurance companies, Wellcare uses a tiered system to categorize the drugs on its formulary. Every covered drug is placed into a tier and each tier comes with its own copayment requirements.
- Tier 1 - Preferred generic drugs and some brand-name drugs
- Tier 2 - Generic drugs and some brand-name drugs
- Tier 3 - Preferred brand-name drugs and some generic drugs
- Tier 4 - Non-preferred brand-name and non-preferred generic drugs
- Tier 5 - High-cost brand-name and generic drugs
Each Wellcare Medicare Advantage and Medicare Part D plan may offer slightly different coverage within each tier.
Do All Medicare Part D Plans Have the Same Formulary?
Each insurance company may create its own drug formulary to use with its Medicare Advantage plans and Medicare Part D plans. There are certain drugs that are required by law to be included on a formulary and other drugs that are not allowed to be included.
But within these parameters, companies like Wellcare may dictate their own formularies, and each formulary can look slightly different from one company or plan to another.
What Types of Medications Are Not Covered on a Medicare Formulary?
While a Wellcare drug formulary covers a wide range of medications, there remains a handful of drugs that are not allowed to be included on any Medicare formulary. The following drugs are prohibited by law from being included on a Medicare Advantage or Medicare Part D formulary:
- Drugs to treat anorexia, weight loss or weight gain
- Fertility drugs
- Medications taken for cosmetic purposes
- Cold or cough medications
- Drugs taken for erectile dysfunction
- Prescription vitamins and minerals
Over-the-counter drugs are not allowed to be included on a formulary. However, many Medicare plans offer coverage or allowances of over-the-counter drugs as an added benefit that is separate from the plan’s formulary.
Meanwhile, the following types of drugs are required to be included on each formulary:
- HIV/AIDS treatment
- Antipsychotic medications
- Anti-convulsive treatments for seizure disorders
- Immunosuppressant drugs
- Anticancer drugs not covered by Medicare Part B
- Vaccines not covered by Medicare Part B
Contact a licensed insurance agent to learn more about whether a Wellcare Medicare Advantage available where you live will cover your medications.