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​Covered Drugs/ Formularies

The Pharmacy Benefit Manager for all UCare members is Express Scripts, Inc. (ESI).

Minnesota Health Care Programs

UCare Connect (SNBC)  | MinnesotaCare | Prepaid Medical Assistance Program (PMAP) | Minnesota Senior Care Plus (MSC Plus)

2013 Injectible Drugs Authorization Guide  
2013 Formulary & OTC Formulary - Minnesota Health Care Programs 
2013 Medicare Eligible UCare Connect and Minnesota Senior Care Plus Formulary 

Prior authorization requests
Telephone (preferred): 1-877-558-7523
Or fax these forms to: 1-800-357-9577
Prior Authorization Request Form - Minnesota Health Care Programs
Quantity Limit Exception Request Form - Minnesota Health Care Programs 
Non-Formulary Exception Request Form - Minnesota Health Care Programs 

Medicare Advantage and Special Needs Plans

UCare for Seniors | UCare's MSHO

2013 Injectible Drugs Authorization Guide

2013 Comprehensive Formularies
2013 Formulary - UCare for Seniors Essentials RX, Value Plus, Classic, Standard D
2013 Formulary - Group UCare for Seniors
2013 Formulary - UCare's Minnesota Senior Health Options (MSHO)

Drug coverage determination requests
Telephone ESI (preferred method): 1-877-558-7521 
Or fax to 1-877-837-5922: 
Drug Coverage Determination Form - UCare for Seniors 
Member Claim Forms - Medicare Part D Drugs 
UCare for Seniors 
UCare's MSHO
 

Pharmacy & Therapeutics Committee

The Pharmacy & Therapeutics Committee, a group of practicing physicians and pharmacists, meets quarterly to recommend changes to our formulary based on the latest medical literature, consultation with physicians, and information from the U.S. Food and Drug Administration (FDA). 


February 2013 Decisions
November 2012 Decisions
June 2012 Decisions
April 2012 Decisions
January 2012 Decisions
October 2011 Decisions