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On January 1, 2022, some drugs will no longer be covered on our Medicare Part D formulary. To assist our providers, we have included the list below of the most commonly prescribed drugs being removed along with the drug’s 2022 formulary alternative(s). Please refer to the list to identify the appropriate options for your patients.
Product Name
Formulary Alternative
BYDUREON PEN (product discontinued)
BYDUREON BCISE AUTO INJ
AURYXIA
CALCIUM ACETATE (PHOS BINDER) CAP/TAB, SEVELAMER CARBONATE
TRULANCE
LINZESS CAP, LUBIPROSTONE CAP
BRINZOLAMIDE OPHTH SUSP 1%
AZOPT, DORZOLAMIDE
If you determine that it is necessary for your patient to continue to receive the non-formulary drug in 2022, you will need to submit a Coverage Determination request on or after November 1, 2021.
Request forms are located on our website on the Coverage Determinations and Redeterminations for Drugs page www.fideliscare.org/WellcareMedicare/Prescription-Drug-Information or you can call to request authorization.
If you have any questions, please contact Provider Services at 1-888-FIDELIS.