Skip to main content

Get the Medications You Need

Your CCA One Care (Medicare-Medicaid) plan covers a wide range of both over-the-counter and brand-name and generic prescription drugs at no cost to you. 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.

Use our One Care Drug directory to search by drug name or type.

One Care List of Covered Drugs—Formulary (2021)

A list of prescription drugs covered by your CCA One Care plan.

2021 One Care Prior Authorization Criteria

A list of certain drugs that require pre-approval by CCA before they are covered.
Download:

One Care Step Therapy Criteria

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.
Download:

Changes to the List of Covered Drugs

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:

There are no changes to CCA’s list of covered drugs at this time.

What if my drug is not on the list?

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.

We’re Here to Support You

866-610-2273 (TTY 711)
8:00 am to 8:00 pm, Monday through Friday, and 8:00 am to 6:00 pm, Saturday and Sunday