Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2021 formulary specifics

We require that members meet specific prior authorization criteria for Clover to cover certain drugs. Additionally, Clover will only cover some medications after the member has tried less expensive options. Finally, patients with certain chronic conditions who take eight or more prescription medications are eligible for the Clover Health Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. If we remove a drug from our formulary, add prior authorization for a drug, add quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must alert members taking that drug about those changes. If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change, or notify them when they request a refull of that drug (at which time the member will also receive a 30-day supply of that drug). If the Food and Drug Administration deems a drug on our formulary to be unsafe, or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.

Learn about 2022 formulary specifics

Clover will cover certain drugs as long as members meet specific prior authorization criteria. Additionally, Clover will only cover some medications after the member has tried less expensive options.

Patients with certain chronic conditions who take eight or more prescription medications are eligible for our Medication Therapy Management (MTM) program, which works with members' doctors and pharmacists to help provide the greatest benefit from their medications.

Changes to our formulary

Clover may add or remove drugs from our formulary throughout the year. Here are some possible changes and ways that we’ll keep you informed.

We must alert members taking a certain drug if we make any of these changes:

• remove the drug from our formulary
• add prior authorization for the drug
• add quantity limits and/or step-therapy restrictions on the drug
• move the drug to a higher cost-sharing tier
• If we're removing a drug from our formulary, we'll either notify affected members 30 days prior to making that change or notify them when they request a refill of that drug (at which time the member will also receive a 30-day supply of the drug).
• If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, we'll immediately remove the drug from our formulary and provide notice to members taking that drug.