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Medicare 2025 Alternative Drugs Covered

Date: 11/11/24

2025 Alternative Covered Drugs

WELLCARE COVERS OVER 40,000 DRUGS.

We strive to cover the most common drugs across all conditions. Below are some common drugs not covered by the plan, along with alternative drugs that are covered. If your patient is currently on a drug that is not covered, please see if the formulary alternatives listed below would work for your patient.

You can also check our plan’s formulary (drug list) for a comprehensive listing of all drugs that are covered and any formulary restrictions that may apply.

Generics and authorized generics listed in the table below with the double asterisk (**) have the same active ingredients as the drug not covered on the formulary. If your patient has an active prescription for a drug not covered, they will still be able to access the listed double-asterisked drug without needing a new prescription.

Drug(s) not covered on the FormularyDrug(s) covered on the ForumlaryFormulary restrictions 
Novolog®Insulin aspart**None
Novolog 70/30®Insulin aspart 70/30*None
Humalog,® Fiasp,® Insulin LisproInsulin aspartNone
Semglee®Insulin Glargine-YFGN pen**None
Basaglar Kwikpen,® Lantus,® Levemir®Insulin Glargine-YFGN penNone
Toujeo®Insulin Glargine 300U/ml**None
Tresiba®Insulin Degludec**None

 

For more than 20 years, Wellcare has offered a range of Medicareproducts, which offer affordable coverage beyond Original Medicare.Beginning Jan. 1, 2022, our affiliated Medicare product brands,including Allwell, Health Net, Fidelis Care, Trillium Advantage, and ‘Ohana Health Plan transitioned to the newly refreshed Wellcare brand.If you have any questions, please contact Provider Relations.

Drug(s)  not covered on the FormularyDrug(s)  covered on the FormularyFormulary  restrictions
Victoza,® Byetta®Bydureon BCISE,® Mounjaro,® Ozempic,®Rybelsus,® Trulicity®PA, QL
Advair Diskus,® Wixela®Fluticasone-Salmeterol Diskus,** Breyna,®  Breo Ellipta,® Advair HFA®QL
Symbicort®Breyna,®** Fluticasone-Salmeterol Diskus,  Breo Ellipta,® Advair HFA®QL
Dulera®Breyna,® Fluticasone-Salmeterol Diskus,  Breo Ellipta,® Advair HFA®QL
Pulmicort Flexhaler,® Fluticasone Propionate DiskusArnuity Ellipta®QL
Levalbuterol HFAAlbuterol HFA, Ventolin HFA®QL
Spiriva Handihaler,® Spiriva Respimat®Incruse Ellipta®QL
Gemtesa,® FesoterodineTolterodine, Solifenacin, Oxybutynin IR, Oxybutynin ER, Myrbetric®QL
SilodosinTamsulosin, Alfuzosin, Finasteride 5mg tablet Dutasteride 0.5mg capsuleNone
Emgality®Aimovig®QL
Repatha®Praluent®PA, QL
Omega-3 Ethyl EsterSVascepa®PA
Veltassa®Lokelma®None
Vyzulta®Latanoprost, Travoprost, Lumigan®None
Simbrinza®Alphagan P 0.1%,® Brimonidine 0.2%, Brimonidine 0.15%, Combigan,®Dorzolamide HCl 2%, Dorzolamide-Timolol, Brinzolamide 1%None
Restasis 0.05% eye drops®Cyclosporine 0.05% eye drops**QL
Forteo®Teriparatide 620mcg/2.48ml Prolia®PA, QL
Procrit®Retacrit®PA
Xeljanz,® Xeljanz XR®Cyltezo 40mg/0.8ml,® Yuflyma,® Humira,® Enbrel,® Rinvoq,® Skyrizi,® Stelara,® Cosentyx,® Tremfya,® Otezla,® Actemra®PA, QL
 Bold type = Brand name drugPlain (not bolded) type = Generic alternative
**Therapeutically equivalent generic PA = Prior Authorization                      QL = Quantity Limi

 

Please note: Alternative drugs are suggestions only and may not be right for every patient or their condition. This information is correct as of October 1, 2024, but is subject to change. Please check the drug list for details on which drugs are covered, as this drug list can change at any time.