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Wellcare 2023 Formulary Changes

Date: 11/07/22

On January 1, 2023, 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 2023 formulary alternative(s).

Wellcare 2023 Formulary Changes
Product NameFormulary Alternative
OZEMPIC INJ 2/1.5ML (1MG/DOSE)OZEMPIC INJ 2MG/1.5ML (0.25 OR 0.5MG/DOSE), OZEMPIC INJ 4MG/3ML (1MG/DOSE), OZEMPIC INJ 8MG/ML (2MG/DOSE) - NEW  
TIMOLOL MAL SOL 0.5% (generic for once daily Istalol)TIMOLOL MAL SOL 0.25%, 0.5% (generic for twice daily Timoptic), TIMOLOL GEL SOL 0.25%, 0.5% (generic for once daily Timoptic-XE gel sol)

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 November 1, 2022.

Request forms are located on our website on the Coverage Determinations and Redeterminations for Drugs page at www.Wellcare.com/healthnetOR and www.Wellcare.com/trilliumOR or you can call to request authorization.

If you have any questions, please contact Medicare Pharmacy Services at 1-800-867-6564.