Pharmacy Information for Providers
Search for Covered Drugs
CCA covers a wide range of both over-the-counter, brand-name and generic prescription drugs at no cost to you. Find out if a medication is covered under your plan and what to do when it’s not.
CCA Medicare Excel Plans Coverage
Real-time Benefit Tool
What’s my out-of-pocket expense? Click below to check up-to-date medication costs at your pharmacy of choice.
Download Our Covered Drugs List
CCA Medicare Excel 001 Drug Formulary (2023)
For some drugs, you will need to get approval (“prior authorization”) from CCA Health before we can agree to cover a drug for your patient. The requirement for getting approval in advance may also help to guide appropriate use of certain drugs. If you do not get this approval, your patient’s drug might not be covered by the plan.
CCA Health Redetermination Form
If your request for coverage for a prescription drug was denied, you have the right to ask for an appeal of our decision.
Medication Transition Process
What can you do if a drug is not on the drug list or if the drug is restricted in some way?
If a drug is not on the drug list or is restricted, here are things you can do:
- Patients 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 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.
Read the document below to learn more.
Drug Quality and Utilization Management
Special rules restrict how and when the plan covers certain drugs. A team of doctors and pharmacists developed these rules to help our members use drugs in the most effective ways. These special rules also help control overall drug costs, which keeps drug coverage more affordable. Read the document below to learn more.