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Extended Day Supply Prescription

Date: 06/14/24

Extended Day Supply Prescription

MAPD (HMO & PPO), CSNP (HMO), & DSNP (HMO)

Extended-Days prescriptions (90 to 100-day supply) give patients asimple way to adhere to taking their medications.

They also offer added convenience.

Standard 30-day fills of maintenance medications require patients to make a trip to the pharmacy every single month,year after year. However, when you write for an extended-day prescription, patients' pharmacy trips drop from 12annual trips to only three.

Members can fill their Extended-Days prescriptions at any willing network pharmacy, but our members may benefit financially if they use Medication Home-Delivery through Express Scripts.® The tablebelow represents the Medicare Advantage formulary benefit for using Medication Home-Deliverythrough Express Scripts,® which includes $0 co-pays for tier 1 and 2 medications and up to $20 savings every month for select medications in Tier 1 through Tier 3, and Tier 6 with an Extended-Days supply.Tier

TierPreferred Home Delivery Cost Benefits
1$0 co-pay
2$0 co-pay
32 x 30-day retail co-pay when applicable
6Greater than 98% claims are $0 co-pay

Express Scripts® is currently our only preferred home-delivery pharmacy. Prescribers can fax or e-prescribe member prescriptions to Express Scripts.® A prescription form and contact information are listed below:

  • ExpressScripts RX Form 
  • Fax: 1-800-837-0959
  • E-prescribe to Express Scripts® Mail Order Electronic, NCPDP ID 2623735

Members must create an account with Express Scripts® online or by telephone at: 1-800-282-2881 (TTY: 711)

Adherence Medication Tiering

The tiering structure for the most common maintenance medications under Wellcare Medicare Advantage plans arelisted below. Please note: This list is not all-inclusive

Medicare Advantage Tiering Structure for Adherence Medications

TierBlood PressureCholesterolOral Diabetes
Tier 1 Preferred Generic   
Tier 2 Generic   
Tier 3 Preferred Brand  
  • Farxiga 
  • Glyxambi
  • Janumet
  • Janumet XR
  • Januvia
  • Jardiance
  • Jentadueto*
  • Jentadueto XR*
  • Rybelsus
  • Synjardy
  • Synjardy XR
  • Tradjenta*
Tier 6§ Select Care
  • Benazepril
  • Enalapril
  • Irbesartan
  • Lisinopril
  • Losartan
  • Olmesartan
  • Valsartan
  • Enalapril/HCTZ
  • Lisinopril/HCTZ
  • Losartan/HCTZ
  • Valsartan/HCTZ
  • Amlodipine/Benazepril
  • Amlodipine/Valsartan
  • Atorvastatin
  • Lovastatin
  • Pravastatin
  • Rosuvastatin
  • Simvastatin
  • Ezetimibe/Simvastatin
  • Glimepiride
  • Glipizide
  • Glipizide ER
  • Glipizide/Metformin
  • Metformin
  • Metformin ER
  • Netaglinide
  • Pioglitazone
  • Pioglitazone/Glimepiride
  • Pioglitazone/Metformin
  • Repaglinide

 

*Jentadueto, Jentadueto XR, and Tradjenta are structured under Tier 4 for 6-Tiered Enhanced Plus Chronic ConditionSpecial Needs Plans (C-SNPs).

§ Select Care medications are structured under Tier 1 for 6-Tiered Enhanced Plus C-SNPs.