UCare's MSHO 2026 List of Covered Drugs (Formulary)
Download the complete Formulary or search the list of covered drugs below.
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Find out what tier your medication is Use the drug search tool below to see whether your medication is covered and what tier it is |
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Find out how much your medication costs Use this tier table to see how much your medication costs |
| Tier | Copay amount |
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| Tier 1 Generic drugs |
$0/$1.60/$5.10 |
| Tier 1 Brand drugs |
$0/$4.90/$12.65 |
| Over-the-Counter (OTC) Drugs | $0 copay |
Important message about what you pay for vaccines - Our plan covers most Part D vaccines at no cost to you. Call customer service for more information.
Formulary documents and information
| Document | Last updated date |
|---|---|
| UCare's MSHO and UCare Connect + Medicare List of Covered Drugs (Formulary) (PDF) |
10/15/2025 |
| Prior Authorization Criteria (PDF) | 10/1/2025 |
| UCare Formulary Exception Criteria (PDF) | 4/28/2025 |
| Formulary Change Notice (PDF) |
Coming soon |
| Diabetic Supplies List (PDF) | 10/1/2025 |
| Non-Preferred CGM and Testing Criteria (PDF) |
10/1/2025 |
| Part B Medical Injectable Drug Authorization List (PDF) | 8/12/2025 |
| UCare’s MSHO and Connect + Medicare Part D Information |