Non-Medicare Prescription Plan - CVS Caremark
Formulary (Covered & Non-Covered Drugs)
A formulary is a list of drugs covered under your prescription plan, and includes both generic and brand name. Drugs that are not covered are considered non-formulary. Products that are not FDA approved will not appear on the formulary, and products recently approved may not be covered on the formulary upon immediate release to the market. In addition, the dosage and administration for drugs on the formulary list will follow current FDA guidance and recommendations. Learn More.
Plan Level Exclusions
Drugs on the State of Delaware Prescription Drug Plan Level Exclusion list are not covered under the State of Delaware Prescription Plan, regardless if they appear on the CVS Caremark Formulary of covered drugs. These excluded drugs are not eligible for consideration under the Coverage Review program. These include, but are not limited to:
- Prescriptions drugs that have OTC equivalents
- Nutritional Supplements
- Blood Glucose Monitors not issued by the Health Plan Diabetes Care Management Program
CVS Caremark Formulary Information
The following documents provide a list of covered and not-covered drugs under your prescription plan effective January 1, 2025:
The following documents provide a list of covered and not-covered drugs under your prescription plan effective October 1, 2024:
If an excluded medication is medically necessary, you may initiate a Coverage Review.
*These medications require a prior authorization due to a formulary exclusion; other clinical prior authorizations may still apply.
