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UCare Medicare Group Plans - nVent / Pentair 2025 Formulary (List of Covered 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 Deductible 30 day supply cost share 90 day supply cost share
Tier 1
Preferred generic drugs
Deductible does not apply to this tier $0 copay Available for two copays through mail order or a preferred network pharmacy
Tier 2
Generic drugs
Deductible does not apply to this tier $0 copay Available for two copays through mail order or a preferred network pharmacy
Tier 3
Preferred brand-name drugs
$100 $40 copay Available for two copays through mail order or a preferred network pharmacy
Tier 4
Non-preferred drugs
$100 $100 copay Available for two copays through mail order or a preferred network pharmacy
Tier 5
Specialty drugs
$100 30% coinsurance Limited to 30-day supply per fill

Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible. Call Customer Service for more information.


Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible.



 

More formulary information

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