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​Find a Prescription Drug

The KelseyCare Advantage plans use a Drug Formulary (a list of prescription drugs approved for coverage by KelseyCare Advantage). KelseyCare Advantage will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a KelseyCare Advantage network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

Part D Temporary Transition Supply
Under certain circumstances, the plan can offer a temporary supply when your drug is not on the Drug List or when it is restricted in some way. These guidelines define the eligibility criteria for a temporary transition supply.  

Drug Search - See if your drug is covered
Search the 2018 KelseyCare Advantage Formulary
This drug search is used for Rx, Rx+Choice and Metropolitan Transit Authority Preferred and Preferred+Choice Plans.
 
This searchable formulary is current as of 8/16/2017. To get additional information about the drugs covered by KelseyCare Advantage or if you would like to request a copy of the Formulary Addendum to be mailed to your home, please call Member Services at 713-442-CARE (2273) or 1-866-535-8343, 8:00 a.m. to 8:00 p.m., seven days a week (October 1 through February 14) and from 8:00 a.m. to 8:00 p.m., Monday through Friday (February 15 through September 30). TTY/TDD users should call 1-866-302-9336
 
​Rx and Rx+Choice Copayments
Preferred Cost-Sharing Pharmacy
Tier
30-Day Supply
90-Day Supply
1
$3
$7.50
2
$17
$42.50
3
$40
$100
4
$60
$150
5
32%
NA* 
Standard Cost-Sharing Pharmacy
Tier
30-Day Supply
90-Day Supply
1
$8
$24
2
$20
$60
3
$45
$135
4
$70
$210
5
32%
NA* 

*A long-term supply is not available for drugs in Tier 5

Formulary Addendum/Changes
The Formulary may change at any time. You will receive notice when necessary. To review and/or print formulary changes made during the year, download the 2018 Formulary Addendum. If you would like to request a copy of the formulary addendum to be mailed to your home, please call Member Services at 713-442-CARE (2273) or 1-866-535-8343, 8:00a.m. to 8:00 p.m., 7 days a week. TTY/TDD users should call 1-866-302-9336.

Documents for Download
Frequently Asked Questions