menu pointer

Follow Us

Prescription coverage

A formulary is the list of prescription drugs covered by ConnectiCare under your plan. If a drug is not in the formulary, then it is not covered (exceptions may apply). A complete list of covered drugs is available below:

2020 ConnectiCare Medicare Advantage Drug Formulary
Document Last Update: 03/2020, H3528_128286_C

2020 ConnectiCare Formulario (Lista de medicamentos cubiertos)
Document Last Update: 03/2020, H3528_128286_C

2020 ConnectiCare Choice Dual (HMO D-SNP) Plan Drug Formulary
Document Last Update: 03/2020, H3276_128287_C

We make updates to our drug lists during the year. We highlight those changes for your convenience in the document below:

2020 ConnectiCare Medicare Advantage Formulary Changes
Document Last Update: 03/2020, Y0026_200180_C


Price a drug

You can estimate the costs of your prescription drugs by using our Price-a-drug tool below:

ConnectiCare Passage Plan 1 (HMO), ConnectiCare Flex Plan 3 (HMO-POS) and ConnectiCare Choice Plan 3 (HMO)
Help me price a drug

ConnectiCare Choice Plan 1 (HMO), ConnectiCare Flex Plan 1 (HMO-POS) and ConnectiCare Flex Plan 2 (HMO-POS)
Help me price a drug

ConnectiCare Choice Dual (HMO D-SNP)
Help me price a drug


Prior authorization criteria

Some covered drugs have additional requirements or limits on coverage. We must approve certain drugs before doctors can prescribe them to you. This is called a prior authorization. It helps us see that drugs are used appropriately and helps guarantee the safety and affordability of medications. Below is a list of drugs that require prior authorization.

2020 Prior Authorization
Document Last Update: 03/2020, Y0026_200168_C

Step therapy criteria

In some cases, we require your doctor to first try certain drugs to treat a medical condition before we will cover another drug. For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B. This is called step therapy. Here is a list of drugs that fall under this requirement.

2020 Step Therapy
Document Last Update: 03/2020, Y0026_200169_C


Coverage determination

If your medication is not listed in the formulary, you have the right to request a coverage determination to receive an exception.


Y0026_200218_C
Last Update 1/1/2020

;