Formulary (List of Covered Drugs)
Search the 2020 Formulary for the Prescription Drugs you may need.
For the Prescription Drugs you may need:www.MolinaHealthcare.com/Medicare.
The formulary is a list of covered drugs. Molina Medicare will generally cover any prescription drug listed in our formulary as long as:
- the drug is medically necessary,
- the prescription is filled at a Molina Medicare network pharmacy,
- and other plan rules are followed.
Can the Formulary Change?
We may add or remove drugs from the formulary during the year. Changes in the formulary may affect which drugs are covered and how much you will pay when filling your prescription. If we remove drugs from the formulary, or add prior authorizations, quantity limits and/or step therapy restrictions on a drug, and you are taking the drug affected by the change, we will notify you of the change at least 60 days before the date that the change becomes effective. However, if a drug is removed from our formulary because the drug has been recalled from the market, we will not give 60 days notice before removing the drug from the formulary. Instead, we will remove the drug from our formulary immediately and notify members about the change as soon as possible.
For more information on covered drugs and how to fill your prescriptions, including obtaining prescriptions at Out-of-Network Pharmacies - Molina Medicare Complete Care (HMO SNP) and how to get a temporary supply of drugs as a new member, see Transition Policy (below). You can ask Molina Medicare to make an exception to our coverage rules by completing the Coverage Determination Request form or the Drug Determination Request Form (see Forms Page).
The files below are in PDF format. ( )
- Changes to the Formulary
- Medication Safety
- Transition Policy
- Rx Mail Order Form
- 2020 Prior Authorization Grid - Molina Medicare Complete Care (HMO SNP)
- 2020 Step Therapy Grid - Molina Medicare Complete Care (HMO SNP)
- 2020 Comprehensive Formulary
- 2021 Prior Authorization Grid
- 2021 Step Therapy Grid
- 2021 Comprehensive Formulary