2025 Alternative Covered Drugs

WELLCARE COVERS OVER 40,000 DRUGS.

We strive to cover the most common drugs across all conditions. Below are some common drugs not covered by the plan, along with alternative drugs that are covered. If your patient is currently on a drug that is not covered, please see if the formulary alternatives listed below would work for your patient.

You can also check our plan’s formulary (drug list) for a comprehensive listing of all drugs that are covered and any formulary restrictions that may apply.

Generics and authorized generics listed in the table below with the double asterisk (**) have the same active ingredients as the drug not covered on the formulary. If your patient has an active prescription for a drug not covered, they will still be able to access the listed double-asterisked drug without needing a new prescription.

Drug(s) not covered on the Formulary	Drug(s) covered on the Formulary	Formulary restrictions
NovoLog	Insulin Aspart**	None
Fiasp, Humalog, Insulin Lispro	Insulin Aspart	None
NovoLog Mix 70/30	Insulin Aspart Mix 70/30**	None
Semglee (yfgn), Lantus	Insulin Glargine-yfgn pen**	None
Basaglar KwikPen, Levemir	Insulin Glargine-yfgn pen	None
Toujeo	Insulin Glargine U-300**	None
Tresiba	Insulin Degludec**	None
Victoza, Byetta	Mounjaro, Ozempic, Trulicity, Rybelsus	PA, QL
Advair Diskus, wixela inhaler	fluticasone-salmeterol diskus** (MAPD only), breyna, Breo Ellipta, Advair HFA	QL
Symbicort	breyna**, fluticasone-salmeterol diskus, Breo Ellipta, Advair HFA	QL
Dulera	breyna, fluticasone-salmeterol diskus, Breo Ellipta, Advair HFA	QL
Pulmicort Flexhaler, Flovent	Arnuity Ellipta	QL
Levalbuterol HFA	albuterol HFA, Ventolin HFA	QL
Spiriva Handihaler & Respimat	Incruse Ellipta	QL
Gemtesa, fesoterodine ER	tolterodine IR/ER, solifenacin, oxybutynin ER, Myrbetriq	QL
Silodosin	oxybutynin IR	None
Silodosin	tamsulosin, alfuzosin ER, finasteride	None
Silodosin	dutasteride, dutasteride-tamsulosin	QL
Repatha	Praluent	PA
omega-3 acid ethyl esters	Vascepa	None
Veltassa	sodium polystyrene sulfonate (SPS), Lokelma	None
Simbrinza	brimonidine 0.15%, brimonidine 0.2%, dorzolamide HCl, dorzolamide-timolol, brinzolamide, Alphagan P 0.1%, Combigan	None
Restasis	Cyclosporine 0.05% drops**	QL
Forteo	Teriparatide 620mcg/2.48mL	PA, QL
Procrit	Retacrit	PA
Xeljanz, Xeljanz XR	Cyltezo low concentration (e.g. 40mg/0.8mL), Yuflyma, Humira (MAPD only), Enbrel, Rinvoq, Skyrizi, Stelara, Cosentyx, Tremfya, Otezla, Actemra	PA, QL

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For more than 20 years, Wellcare has offered a range of Medicare products, which offer affordable coverage beyond Original Medicare. Beginning Jan. 1, 2022, our affiliated Medicare product brands, including Allwell, Health Net, Fidelis Care, Trillium Advantage, and 'Ohana Health Plan transitioned to the newly refreshed Wellcare brand. If you have any questions, please contact Provider Relations.

wellcare
By Allwell
By Fidelis Care
By Health Net
By 'Ohana Health Plan
By Trillium Advantage

Uppercase text = Brand Name Drug
Lowercase text = generic drug
**interchangeable alternative (same active ingredient)
PA = Prior Authorization
QL = Quantity Limit

Please note: Alternative drugs are suggestions only and may not be right for every patient or their condition. This information is correct as of May 8, 2025, but is subject to change. Please check the drug list for details on which drugs are covered, as this drug list can change at any time.

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2025 Alternative Covered Drugs Form

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