CY26 Provider Notification for Non-Formulary Drugs AZ

Date: 11/25/25

2026 Formulary Changes – WellCare Part D

Effective January 1, 2026, certain medications and products will no longer be covered on our Medicare Part D formulary(ies). To support your prescribing decisions, we’re providing the list below of the most commonly prescribed items being removed along with their 2026 formulary alternative(s). Please review the list to identify appropriate options for your patients.

Product Name	Formulary Alternative
OneTouch	Accu-Chek Guide, True Metrix
Insulin Degludec	Insulin Glargine-yfgn, Insulin Glargine U-300
diclofenac 2% solution	diclofenac 1.5% topical solution
Humira (adalimumab)	Cyltezo (adalimumab-adbm)*, Yuflyma (adalimumab-aaty)*, Tyenne (tocilizumab-aazg)*, Steqeyma (ustekinumab-stba)*, Cosentyx*, Otezla*, Rinvoq*, Skyrizi*, Tremfya*
Actemra (tocilizumab)
Austedo, Austedo XR	tetrabenazine*, Ingrezza*
Trulance	lubiprostone, Linzess
Bydureon BCise	Mounjaro*, Ozempic*, Rybelsus*, Trulicity*
Gammagard Liquid	Gamunex-C*
Xultophy	Soliqua
abiraterone 500mg	abiraterone 250mg tab*, abirtega 250mg tab*
Fasenra	Dupixent*, Xolair*
Vivitrol	acamprosate, disulfuram
Opsumit	ambrisentan*, bosentan*, sildenafil 20mg*, tadalafil 20mg*

If you determine it is necessary for your patient to continue to receive the non-formulary option in 2026, please submit a Coverage Determination request on or after January 1, 2026.

Request forms are located on our website  -> Pharmacy Benefits -> Coverage Determinations and Redeterminations or you can call to request authorization.

If you have any questions, please contact Medicare Pharmacy Services at 800-867-6564, 8AM to 10:30PM, EST, Monday – Friday.