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2025 Duals formulary (list of covered drugs)

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Formulary documents and information

Document Last updated date
UCare's MSHO and UCare Connect + Medicare List of Covered Drugs (Formulary) (PDF)
UCare's MSHO and UCare Connect + Medicare List of Covered Drugs (Formulary) Hmong (PDF)
UCare's MSHO and UCare Connect + Medicare List of Covered Drugs (Formulary) Somali (PDF)
9/1/2025
8/1/2025
8/1/2025
Prior Authorization Criteria (PDF) 9/1/2025
UCare Formulary Exception Criteria (PDF) 4/28/2025
Formulary Change Notice (PDF) 6/4/2025
Diabetic Supplies List (PDF) 5/1/2024
Non-Preferred CGM and Testing Criteria (PDF) 10/1/2024
Part B Medical Injectable Drug Authorization List (PDF) 8/12/2025
UCare’s MSHO and Connect + Medicare Part D Information  

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