Covered Drugs for CCA Excel Plan Members
Get the Medications You Need
Your CCA Medicare Excel (HMO) plans cover a wide range of drugs. Use the resources below to find out if a medication is covered by CCA Health California (CCA Health) and if it requires step therapy or pre-approval.
CCA Medicare Excel (HMO) San Joaquin, Stanislaus, and Merced counties (Plan 001)
We also cover a wide range of brand-name and generic drugs. Use our digital directories to search for a pharmacy or prescription.
CCA Medicare Excel (HMO) San Joaquin, Stanislaus, and Merced counties (Plan 001) Covered Drug Documents
CCA Medicare Excel (HMO) Plan 001 and Plan 002 (CA) – Drug Formulary (2024)
CCA Medicare Excel (HMO) Plan 001 and Plan 002 (CA) – Prior Authorization Criteria (2024)
CCA Medicare Excel (HMO) Plan 001 and Plan 002 (CA) – Step Therapy Criteria (2024)
CCA Medicare Excel (HMO) Santa Clara County (Plan 002)
We also cover a wide range of brand-name and generic drugs. Use our digital directories to search for a pharmacy or prescription.
CCA Medicare Excel (HMO) Santa Clara County (Plan 002) Covered Drug Documents
CCA Medicare Excel (HMO) Plan 001 and Plan 002 (CA) – Drug Formulary (2024)
CCA Medicare Excel (HMO) Plan 001 and Plan 002 (CA) – Prior Authorization Criteria (2024)
CCA Medicare Excel (HMO) Plan 001 and Plan 002 (CA) – Step Therapy Criteria (2024)
Medication Transition Process
What can you do if your drug is not on the drug list or if the drug is restricted in some way?
If your drug is not on the drug list or is restricted, here are things you can do:
- You may be able to get a temporary supply of the drug (only members in certain situations can get a temporary supply). This will give you and your doctor time to change to another drug or to file an exception.
- You can change to another drug.
- You can request an exception and ask the plan to cover the drug or remove restrictions from the drug.
You may be able to get a temporary supply
Under certain circumstances, the plan can offer a temporary supply (transition fill) of a drug when your drug is not on the list or when it is restricted in some way. Doing this gives you time to talk with your doctor about the change in coverage and figure out what to do. To be eligible for a temporary supply, you must be in one of the situations described below:
We will cover a temporary supply of your drug during the first 90 days of the calendar year. This temporary supply will be for a maximum of 31 days. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of a 31-day supply of medication. The prescription must be filled at a network pharmacy.
We will cover a temporary supply of your drug during the first 90 days of your membership in the plan. This temporary supply will be for a maximum of 31 days. If your prescription is written for fewer days, we allow multiple fills to provide up to a maximum of a 31-day supply of medication. The prescription must be filled at a network pharmacy.
We will cover a temporary supply of your drug during the first 90 days of your membership in the plan. The total supply will be for a maximum of 30 days. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of a 30-day supply of medication. (Please note that the long-term care pharmacy may provide the drug in smaller amounts at a time to prevent waste.)
We will cover a temporary supply of your drug during the first 90 days of your membership in the plan. The total supply will be for a maximum of 30 days. If your prescription is written for fewer days, we will allow multiple fills to provide up to a maximum of a 30-day supply of medication. (Please note that the long-term care pharmacy may provide the drug in smaller amounts at a time to prevent waste.).
We will cover one 30-day supply, or less if your prescription is written for fewer days. This is in addition to the above long-term care transition supply.
We will cover a temporary supply for up to 31 days, or less if your prescription is written for fewer days, even if the drug is not on our formulary or the drug is subject to certain restrictions such as prior authorization or step therapy. The drug must be a Part D covered drug. The prescription must be filled at a network pharmacy.
We will send a letter after we cover a temporary supply of drugs.
We will provide you with a written notice after we cover a temporary supply. This notice will explain the steps to request an exception and how to work with the provider to switch to an appropriate drug that we cover. After we cover the temporary supply, we may not pay for the drug again as part of our transition policy.
During the time when you are getting a temporary supply of a drug, you should talk with your provider to decide what to do when your temporary supply runs out. You can either switch to a different drug covered by the plan or ask the plan to make an exception for you and cover your current drug.