Formulary (List of Covered Drugs)

For the Prescription Drugs you may need:
Search the 2020 Formulary (Molina Medicare Choice Care (HMO))
Search the 2020 Formulary (Molina Medicare Complete Care (HMO SNP))

Search the 2021 Formulary (Molina Medicare Choice Care (HMO))
Search the 2021 Formulary (Molina Medicare Complete Care (HMO SNP))

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.

Healthy Advantage will generally cover any prescription drug listed in our formulary as long as:

  • the drug is medically necessary,
  • the prescription is filled at a Healthy Advantage 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 30 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 30 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.

 The files below are in PDF format. (icon PDF)

Molina Medicare Complete Care (HMO SNP)

For more information on covered drugs and how to fill your prescriptions, including obtaining prescriptions at Out-of-Network pharmacies Molina Medicare Complete Care and how to get a temporary supply of drugs as a new member see transition policy PDF. 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).

Molina Medicare Choice Care (HMO)

For more information on covered drugs and how to fill your prescriptions, including obtaining prescriptions at Out-of-Network pharmacies Molina Medicare Choice Care and how to get a temporary supply of drugs as a new member see transition policy PDF. 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).

     

Plan Materials

Molina Medicare Complete Care (HMO SNP)   |  Molina Medicare Choice Care (HMO)

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