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 2023 Covered Drug Lists (Formularies)

2024 Covered Drug Lists (Formularies)

 


Prior Authorization Requests and Formulary Exceptions

Specialty Drug Program  

Medica relies on preferred vendors to manage specialty drugs for members. Accredo Specialty Pharmacy is our preferred Specialty Drug Program vendor.

Members who have questions about their specialty drug coverage should call the Customer Service number listed on the back of their Medica ID card.

For access to specialty drug referral forms, visit Accredo Specialty Pharmacy’s referral form page, or call Accredo Specialty Pharmacy at 1-866-544-6817.

Diabetic Meters

 Freestyle® blood glucose meters and testing supplies are on Medica's formulary as the preferred option for Individual & Family Business.  Accu-Chek®  and Contour®blood glucose meters and testing supplies are on Medica's formulary as the preferred option for Commercial.

 
Date: 4/20/2024 1:24:22 AM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB01