2026 Wellcare Formulary Changes
Date: 11/20/25
On January 1, 2026, some drugs will no longer be covered on our Medicare Part D formulary(ies). To assist our providers, we have included the list below of the most commonly prescribed drugs being removed along with the drug’s 2026 formulary alternative(s). Please refer to the list to identify the appropriate options for your patients.
Product Name | Formulary Alternative |
|---|---|
OneTouch | Accu-Chek Guide, True Metrix |
Insulin Degludec | Insulin Glargine-yfgn, Insulin Glargine U-300 |
diclofenac 2% solution | diclofenac 1.5% topical solution |
Humira (adalimumab) | Cyltezo (adalimumab-adbm)*, Yuflyma (adalimumab-aaty)*, Tyenne (tocilizumab-aazg)*, Steqeyma (ustekinumab-stba)*, Cosentyx*, Otezla*, Rinvoq*, Skyrizi*, Tremfya* |
Actemra (tocilizumab) | |
Austedo, Austedo XR | tetrabenazine*, Ingrezza* |
Trulance | lubiprostone, Linzess |
Bydureon BCise | Mounjaro*, Ozempic*, Rybelsus*, Trulicity* |
Gammagard Liquid | Gamunex-C* |
Xultophy | Soliqua |
abiraterone 500mg | abiraterone 250mg tab*, abirtega 250mg tab* |
Fasenra | Dupixent*, Xolair* |
Vivitrol | acamprosate, disulfiram |
Opsumit | ambrisentan*, bosentan*, sildenafil 20mg*, tadalafil 20mg* |
* Prior Authorization Required | |
If you determine that it is necessary for your patient to continue to receive the non-formulary drug in 2026, you will need to submit a Coverage Determination request on or after January 1, 2026.
Request forms are located on our website on the Coverage Determinations and Redeterminations for Drugs page go.wellcare.com/WI or you can call to request authorization.
If you have any questions, please contact Medicare Pharmacy Services at 1-800-867-6564, 8AM to 10:30PM, EST, Monday – Friday.
Member Services:
DSNP: 1-844-796-6811
MAPD: 1-800-977-7522
Prior Authorization:
Phone: 1-800-867-6564
Fax: 1-866-226-1093