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Get the medications you need

Your CCA Medicare Maximum (HMO D-SNP) plan covers a wide range of both brand-name and generic prescription drugs at no cost to you. Use the resources below to find out if a medication is covered by CCA Health Michigan and if it requires step therapy or pre-approval.

CCA Medicare Dual Special Needs

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 Maximum Covered Drug Documents

CCA Medicare Maximum (HMO D-SNP) (MI) – List of Covered Drugs (Formulary) (2024)

CCA Medicare Maximum (HMO D-SNP) – Quantity Limits (2024)

CCA Medicare Maximum (HMO D-SNP) (MI) – Prior Authorization Criteria (2024)

CCA Medicare Maximum (HMO D-SNP) (MI) – Step Therapy Criteria (2024)

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:

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.

We can offer a temporary supply when the drug you have been taking is no longer on the list of drugs CCA Health Michigan covers, or when the drug becomes restricted in some way. (Please note: only members in certain situations can get a temporary supply.) 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 Health Michigan member. Contact CCA Member Services to see if you qualify. 

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