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2022 Wellcare Formulary Changes

Date: 11/10/21

This update applies to: All Network Providers

State(s): Kansas MAPD

Line of Business: Medicare Part D

Member Services:

  • HMO 1-855-565-9519
  • HMO D-SNP 1-833-402-6707
  • PPO 1-833-696-0634

Prior Authorization: 1-800-867-6564

Plan Website: wellcare.sunflowerhealthplan.com

On January 1, 2022, some drugs will no longer be covered on our Medicare Part D formulary. To assist our providers, we have included the list below of the most commonly prescribed drugs being removed along with the drug’s 2022 formulary alternative(s). Please refer to the list to identify the appropriate options for your patients.

Product NameFormulary Alternative
BYDUREON PEN (product discontinued)BYDUREON BCISE AUTO INJ
AURYXIACALCIUM ACETATE (PHOS BINDER) CAP/TAB, SEVELAMER CARBONATE
TRULANCELINZESS CAP, LUBIPROSTONE CAP
BRINZOLAMIDE OPHTH SUSP 1%AZOPT, DORZOLAMIDE

If you determine that it is necessary for your patient to continue to receive the non-formulary drug in 2022, you will need to submit a Coverage Determination request on or after November 1, 2021.

Request forms are located on our website on the Coverage Determinations and Redeterminations for Drugs page or you can call to request authorization.

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