CareMore Health Plan covers both brand name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. The formulary may change during the year.
From time to time, there may be a change in tiered costs and/or removal made in the formulary. CareMore will post a 60-day advance notice of any changes to our formulary below.
You must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which CareMore authorizes use of out-of-network providers. If you obtain routine care from out-of-network providers neither Medicare nor CareMore will be responsible for the costs.
CareMore Health Plan has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area with 64,831 pharmacies in our network.
CareMore Health Plans Online Formulary Search / Prior Authorization Form
(How do I request an exception to the CareMore Health Plan's Formulary?)
Printable Formulary (Opens a PDF)
PLEASE NOTE: Our drug list is updated monthly. For the most current list of drugs on the formulary, please refer to the "2015 CareMore Health Plans Online Formulary Search" tool on the website or call Member Services at 1-800-499-2793 (TTY users should call: 711). Representatives are available 8 a.m. - 8 p.m., 7 days a week (October 1 - February 14) and Monday - Friday (February 15 -September 30).
2015 Pharmacy Search
Printable Provider / Pharmacy Directory (Opens a PDF)
CMS' Best Available Evidence (BAE) Policy (This link will take you to the CMS website)