Your drug coverage
Learn which drugs are covered by your Molina Healthcare of California plan, where to get them filled and how to check your drug formulary.
Your drug formulary is the list of medicines covered by your plan. Use the drug search tool below to search by name and see if a drug needs approval or has limits.
Covered drugs are grouped by cost tiers. Generic drugs usually cost less than brand or specialty drugs. Your copay or coinsurance depends on the tier.
The drug formulary can change each year. Updates start on January 1 and are shown on the formulary changes grid. You can also find the full drug formulary on the Materials page.
Prescriptions are covered at in-network pharmacies. Out-of-network coverage may be limited to emergencies or urgent needs. If you have trouble at the pharmacy, please do not pay for the prescription. Contact us for help.
How the drug formulary works
CVS Caremark provides drug benefits for your health plan. To see if your drug is covered, view the drug formulary.
To start mail order service, here’s what you need to do:
1. Call CVS Caremark at (800) 875-0867. Be prepared to tell them your member ID number, the name of your prescription, and your doctor’s name and phone number. They will also need your mailing address.
2. Ask your doctor to send an electronic prescription to CVS Caremark or have them call (800) 378-5697 with your member ID number, date of birth and your mailing address.
3. Complete and send the mail service order form.
If you need specialty medications
Specialty medications require special handling, complex counseling or monitoring, limited distribution or other specialty pharmacy requirements. Specialty medications are placed in the specialty tier on the drug formulary. To start specialty medication service, please contact the CVS Pharmacy Help Desk at (888) 407-6425.