New Hampshire Medicare Advantage drug list

Type WellSense Added Value HMO WellSense Choice HMO WellSense Signature HMO WellSense Premium Savings HMO
List of Covered Drugs (Formulary)
Prior Authorization drug list Prior Authorization drug list (updated 8/30/24) Prior Authorization drug list (updated 8/30/24) Prior Authorization drug list (updated 8/30/24) Prior Authorization drug list (updated 8/30/24)
Step Therapy drug list Step Therapy drug list (updated 8/30/24) Step Therapy drug list (updated 8/30/24) Step Therapy drug list (updated 8/30/24) Step Therapy drug list (updated 8/30/24)

 

WellSense covers both brand-name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs.

Some drugs may have restrictions or require approval before you can get them

There may be restrictions on certain drugs in our drug list. These drugs have special rules that must be followed before you can get them. For example, your doctor may need to prove that a certain drug is necessary for your health before a drug will be covered.

Drugs will have codes listed next to them that help explain the restriction. Look up the meanings of those codes. To request approval for a drug that is not covered or restricted, you can submit a request.

WellSense covers both brand-name drugs and generic drugs. Generic drugs have the same active ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs. If you have questions about your prescription drug plan or the cost of your medications, please contact our partner Express Scripts at 800-849-9080.

2024 plans

2025 plans

Some drugs may have restrictions or require approval before you can get them

There may be restrictions on certain drugs in our drug list. These drugs have special rules that must be followed before you can get them. For example, your doctor may need to prove that a certain drug is necessary for your health before a drug will be covered.

Drugs will have codes listed next to them that help explain the restriction. Look up the meanings of those codes. To request approval for a drug that is not covered or restricted, you can submit a request.

Limitations and restrictions may apply. Benefits, formulary, pharmacy network and provider network may change on January 1 of each year. You will receive notice when necessary. For more information, contact us.