Wellcare 2024 Formulary Changes
Date: 12/06/23
This notice is for Wellcare By Health Net and Wellcare By Trillium Advantage network providers.
On January 1, 2024, some drugs will no longer be covered on our Medicare Part D Plan formulary(ies). To assist our providers, we have included the list below of the most commonly prescribed drugs being removed along with the drug’s 2024 formulary alternative(s). Please refer to the list to identify the most appropriate options for your patients:
Product Name: Lantus vial, Lantus SoloStar
Formulary Alternative: Basaglar KwikPen, Toujeo SoloStar, Toujeo Max SoloStar, Tresiba vial, Tresiba FlexTouch
Product Name: Levemir vial, Levemir FlexPen
Formulary Alternative: Basaglar KwikPen, Toujeo SoloStar, Toujeo Max SoloStar, Tresiba vial, Tresiba FlexTouch
Product Name: Victoza pen injector
Formulary Alternative: Bydureon Bcise auto-injector*, Mounjaro pen injector*, Ozempic pen injector*, Rybelsus tablet*, Trulicity pen injector*
Product Name: Byetta pen injector
Formulary Alternative: Bydureon Bcise auto-injector*, Mounjaro pen injector*, Ozempic pen injector*, Rybelsus tablet*, Trulicity pen injector*
Product Name: Flovent Diskus, Flovent HFA inhaler (Discontinued by manufacturer)
Formulary Alternative: Arnuity Ellipta, Pulmicort Flexhaler
Product Name: Kevzara pen injector, Kevzara syringe
Formulary Alternative: Diagnosis dependent: Enbrel injection*, Humira injection*, Rinvoq tablet*, Xeljanz tablet*, Xeljanz XR tablet*
Product Name: Ingrezza capsule
Formulary Alternative: Austedo tablet*, Tetrabenazine tablet*
Product Name: Betoptic-S suspension eye drops
Formulary Alternative: Alphagan P 0.1% eye drops, Brimonidine Tartrate eye drops, Combigan eye drops
*Prior authorization required.
If you determine that it is necessary for your patient to continue to receive the non-formulary drug in 2023, you will need to submit a Coverage Determination request on or after December 15, 2023..
Request forms are located on our website on the Coverage Determinations and Redeterminations for Drugs page on the health plan website or you can call to request authorization.
- Wellcare By Health Net
- Member Services: 1-844-582-5177
- Prior Authorization: 1-800-867-6564
- Wellcare By Health Net Oregon Website
- Wellcare By Trillium Advantage
- Member Services: 1-844-867-1156
- Prior Authorization: 1-800-867-6564
- Wellcare By Trillium Advantage Website
If you have any questions, please contact Medicare Pharmacy Services at 1-800-867-6564.