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Get the medications you need

Our CCA Medicare Preferred (PPO) and CCA Medicare Value (PPO) plans cover a wide range of both brand-name and generic prescription drugs. Use the resources below to find out if a medication is covered by Commonwealth Care Alliance and if it requires step therapy or pre-approval.

CCA Medicare Preferred

We also cover a wide range of brand-name and generic drugs. Use our digital drug list to search by name or drug type.

To change your primary care provider or get detailed information about your healthcare benefits and prior authorization requirements, call our Member Services team at 866-610-2273 (TTY 711).

CCA Medicare Preferred Covered Drug Documents

CCA Medicare Preferred List of Covered Drugs (MA) – Formulary (2024)

A document that provides details on which prescription drugs, over-the-counter drugs, and items are covered by CCA Medicare Preferred.

CCA Medicare Preferred (MA) – Prior Authorization Criteria (2024)

A document that details the criteria you must meet to receive authorization for a drug.

CCA Medicare Preferred (MA) – Step Therapy Criteria (2024)

A list of certain drugs that require step therapy. Step therapy encourages you to try less expensive but just as effective drugs first. For example, if Drug A and Drug B treat the same medical condition, the plan may require you to try Drug A first. If Drug A does not work for you, the plan will then cover Drug B.

CCA Medicare Value

We also cover a wide range of brand-name and generic drugs. Use our digital drug list to search by name or drug type.

CCA Medicare Value Covered Drug Documents

CCA Medicare Value List of Covered Drugs (MA) – Formulary (2024)

A document that provides details on which prescription drugs, over-the-counter drugs, and items are covered by CCA Medicare Value.

CCA Medicare Value (MA) – Prior Authorization Criteria (2024)

A document that details the criteria you must meet to receive authorization for a drug.

CCA Medicare Value (MA) – Step Therapy Criteria (2024)

A list of certain drugs that require step therapy. Step therapy encourages you to try less expensive but just as effective drugs first. For example, if Drug A and Drug B treat the same medical condition, the plan may require you to try Drug A first. If Drug A does not work for you, the plan will then cover Drug B.

Additional Covered Drug Member Information

Information about your covered drug benefits that help you with your daily living.

CCA partners with Abbott Diabetes Care and LifeScan Products to provide the following diabetes test strip products. Some restrictions may apply.

Abbott Products

  • FreeStyle Precision Neo® Meter
  • FreeStyle Precision Neo® Test Strips
  • FreeStyle Lite® Meter
  • FreeStyle Freedom Lite® Meter
  • FreeStyle Lite ® Test Strips
  • FreeStyle® Lancets
  • Freestyle® Test Strips
  • Freestyle InsuLinx ® Test Strips
  • Precision Xtra ® Meter
  • Precision Xtra® Test Strips
  • Precision Xtra Beta Ketone® Test Strips

LifeScan Products

  • OneTouch Ultra 2® Meter
  • OneTouch Ultra Mini® Meterr
  • OneTouch Ultra ® Test Strips
  • OneTouch Verio® Meter
  • OneTouch Verio® Reflect Meter
  • OneTouch Verio® Flex Meter
  • OneTouch Verio® Test Strips
  • OneTouch Delica® Lancets
  • OneTouch Delica® Plus Lancets
  • OneTouch Delica® Ultrasoft Lancets

Continuous Glucose Monitors (CGMs) – PA required:

  • Dexcom G6 ® Transmitter, Receiver and Sensor
  • Dexcom G7 ® Receiver and Sensor
  • Freestyle Libre ® Receiver and Sensor
  • Freestyle Libre 2 ® Receiver and Sensor
  • Freestyle Libre 3 ® Reader, Receiver and Sensor

If you or your doctor believe you should use a different diabetes care product than those listed above, you may request an exception through the prior authorization process. Click here for information on how to request a prior authorization.

We may add or remove drugs from the list of covered drugs during the year. If we remove a drug or make a change regarding a drug you use, we will notify you at least 60 days before the change becomes effective. However, if the Food and Drug Administration (FDA) determines that a drug on our list is unsafe, or if the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our list of covered drugs and notify you. Learn more about drug recalls.

You can view the latest updates to our list of covered drugs below:

If your drug is not included in the list of covered drugs, you should first contact CCA Member Services and confirm that your drug is not covered. If we do not cover your drug, you have two options:

  1. Ask Member Services for a list of similar drugs that are covered. Show the list to your doctor and ask him or her to prescribe a similar drug that we cover.
  2. Ask us to make an exception and cover your drug. Click here for information about how to file a pharmacy appeal.

In some cases, we can offer a temporary supply when the drug you have been taking is no longer on our list of covered drugs, or when the drug becomes restricted in some way. A temporary supply can give you time to talk with your doctor about what to do.

There are different rules for getting a temporary supply depending on your status as a CCA member. Contact CCA Member Services to see if you qualify.

Visit our Pharmacy Information page for more information on your pharmacy benefits.

As a new or continuing member in our plan, you may be taking drugs that are not on our formulary. Or you may be taking a drug that is on our formulary, but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan.

For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 31-day supply. If your prescription is written for fewer days, we’ll allow refills to provide up to a maximum 31-day supply of medication. After your first 31-day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days.

If you are a resident of a long-term care facility and you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our plan, we will cover a 31-day emergency supply of that drug while you pursue a formulary exception.

We will provide an emergency supply of at least 31 days (unless the prescription is written for fewer days) for all non-formulary medications, including those that may have step therapy or prior authorization requirements for an unplanned level of care change. An unplanned level of care transition could be any of the following:

• A discharge or admission to a long-term care facility

• A discharge or admission to a hospital

• A nursing facility skilled level change

To change your primary care provider or get detailed information about your healthcare benefits and prior authorization requirements, call our Member Services team at 866-610-2273 (TTY 711).

We’re here to support you

866-610-2273 (TTY 711)
8 am – 8 pm, 7 days a week