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UCare Advocate Choice 2022 Formulary (List of Covered Drugs)

Download the complete Formulary or search the list of covered drugs below.

Tier Deductible 30 day supply - standard cost share 90 day supply - preferred mail order
Tier 1
Preferred generic drugs
Deductible does not apply to this tier $5 copay Available for two copays
Tier 2
Generic drugs
$395 $13 copay Available for two copays
Tier 3
Preferred brand drugs
$395 $47 copay Available for two copays
Select insulins Deductible does not apply to select insulin $35 copay
Tier 4
Non-preferred drugs
$395 25% coinsurance Available for 25% coinsurance
Tier 5
Specialty drugs
$395 25% coinsurance Available for 25% coinsurance