Your drug coverage
Learn which drugs are covered by your Molina Healthcare of Wisconsin plan, where to get them filled and how to check your formulary.
How your coverage works
Your drug list, also called a formulary, is the list of medicines covered by your plan. Use the drug search tool below to search by name and see any notes, like 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 formulary can change each year. Updates that start on January 1. 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 formulary works
Members get their medicine from any in-network pharmacy. Use the Pharmacy Locator to find a location in your service area. You can look up covered medicine using the online drug formulary and drug search tool below. We can mail many long-term medicines to members that usually arrive within 10 days. Members can order by mail, by calling the FastStart number or by having their doctor send in the prescription.
To see if your drug is covered, use the On-Page Location Selector
Select your plan to look up covered drugs. Please note that these links will take you to an external website.
View your state’s formulary.
Your cost depends on the drug and your plan benefits.
Your plan has a network of Mail Order pharmacies that can process and dispense up to 90 days' supply of eligible medications.
A 90-day supply may cost 3 times your one-month copay or coinsurance.
Your plan’s network also offers 90-day fill at network retail pharmacies. If you are looking for retail pharmacies that participate in the 90-day fill at retail program, participating pharmacies will show “90-day Supply Available” in the details of your search results.
Outside your service area, drugs are covered for emergencies only.
To start mail-order service, here’s what you need to do:
Call CVS Caremark FastStart at (800) 875-0867 and provide your member ID number, prescription name, your doctor’s name and phone number and your mailing address.
Ask your doctor to send an electronic prescription or call (800) 378-5697 with your member ID number, date of birth and mailing address.
Complete and send the mail service order form.
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 formulary. To start specialty medication service, please contact the CVS Pharmacy Help Desk at (888) 407-6425 Or visit CVSSpecialty.com.