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MinnesotaCare 2025 Formulary (List of Covered Prescription and Over-the-Counter Drugs)

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

Follow these steps to see the coverage and cost of your medication.

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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
Tier 1
Generic drugs
$7 copay
Tier 1
Brand drugs
$25 copay

 

Notes:

  • No co-pays for pregnant women, children under 21, members in hospice, members residing in a nursing home for 30+ days, or adult members of a federally-recognized American Indian tribe.
  • No co-pays for anti-psychotic drugs
  • 90-day supply available for drugs identified on UCare’s List of Covered Drugs

 

More formulary information

Documents Last updated Date
Minnesota Health Care Programs List of Covered Drugs (Formulary) (PDF) 12/18/2024
Prior Authorization Criteria 1/1/2025
Diabetes Supply List (PDF) 5/1/2024
Medical Injectable Authorization List (PDF) 1/8/2025
Non-Preferred Drug Prior Authorization Criteria (PDF)  
Medication Therapy Management (MTM) — available at no additional cost to members with chronic health conditions who take multiple medicines.  

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