July 1, 2024
Preferred Pharmacy Network Our Medicare Advantage* and Prescription Drug Plans offer a robust, dependable pharmacy network with over 60,000 pharmacies in network — many offering preferred cost-sharing!* A member’s cost-share may be lower when prescriptions are filled through one of our preferred retail pharmacies or our preferred mail-order pharmacy, Express Scripts.® However, members may have prescriptions filled at any network pharmacy. Walgreens,® CVS,® grocers, and select independents pharmacies remain within the preferred 2024 pharmacy network.
Amazon® is no longer a preferred pharmacy but remains in the pharmacy network.
Remember, some retail pharmacies offer both retail and home delivery options. If a member fills a prescription with a retail pharmacy that also offers home delivery, the retail cost share will apply, and pharmacies may charge a delivery fee.
Please utilize the Find a Provider tool to find an in-network pharmacy. This will also allow you to find an in-network pharmacy’s network status (standard vs preferred and if 90/100-day fill is offered). *Preferred pharmacy network not available for Wellcare D-SNPs.
Formulary Updates
Beginning January 1, 2024, MAPD members will be able to receive up to a 100-day supply of qualifying medications with each fill for non-specialty medications at all in-network pharmacies.
The formulary GLP-1 agonists Bydureon Bcise,® Mounjaro,® Ozempic,® Rybelsus,® and Trulicity® will require a prior authorization (PA) to confirm medically-appropriate use for the treatment of type 2 diabetes (not covered for weight loss, pre-diabetes, type 1 diabetes, or heart disease prevention). The PA applies to all new and existing users of GLP-1 agonists.
Effective January 1, 2024, Express Scripts Pharmacy® replaced CVS Caremark® as our preferred mail order provider. CVS Caremark Mail Order® is out-of-network in 2024.
For Existing Mail Order Users:
Most open prescription refills were automatically transferred to Express Scripts.® Refills of controlled drugs were NOT automatically transferred. Members will need to request new prescriptions from their providers.
Members who need new mail-order prescriptions may either:
- Visit express-scripts.com/rx to register or sign in, then follow the guided steps to request a prescription;
- OR call Express Scripts Pharmacy® at 1-800-282-2881 or 1-833-750-0201.
