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UCare Advocate Plus 2022 Formulary (List of Covered Drugs)

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

UCare Medicare and EssentiaCare Formulary (List of Covered Drugs) (PDF) Updated 12/1/22

Prior Authorization Criteria (PDF) Updated 12/1/22
UCare Formulary Exception Criteria (PDF) Updated 1/21/22
Formulary Change Notice (PDF) Updated 8/18/22

Part B Medical Injectable Drug Authorization List (PDF) Updated 11/15/22

Part D Information
EssentiaCare Part D Information

Prescription Drug Calculator










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 $4 copay Available for two copays
Tier 2
Generic drugs		 Deductible does not apply to this tier $12 copay Available for two copays
Tier 3
Preferred brand drugs		 $250 $45 copay Available for two copays
Select insulins Deductible does not apply to select insulin $35 copay
Tier 4
Non-preferred drugs		 $250 25% coinsurance Available for 25% coinsurance
Tier 5
Specialty drugs		 $250 25% coinsurance Available for 25% coinsurance