Formulary (Pharmacy and Part D)

The formulary is a list of drugs Clover covers for medically necessary purposes. Clover also partners with in-network pharmacies, which may provide medications at a lower cost.

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Formulary information for 2021 Arizona plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Arizona plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Arizona plans • Download

 Search 2021 Pharmacies


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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Formulary information for 2021 Georgia plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Georgia plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

 

 

All Georgia Plans • Download

Search 2021 Pharmacies


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.
 


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


 

Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478

 

Formulary information for 2021 New Jersey plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All New Jersey plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All New Jersey plans • Download

Search 2021 Pharmacies


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.

 


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number for PPO Plans
1-855-479-3657

Phone Number for HMO Plans
1-844-232-2316


Formulary information for 2021 Pennsylvania plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Pennsylvania plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Pennsylvania plans • Download

Search 2021 Pharmacies


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.

 


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478

 

Formulary information for 2021 South Carolina plans

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All South Carolina plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All South Carolina plans • Download

Search 2021 Pharmacies


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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


 

Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478

 

Formulary information for 2021 Tennessee plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Tennessee plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Tennessee plans • Download

Search 2021 Pharmacies


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.

 


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478
 

Formulary information for 2021 Texas plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Texas plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

All Texas Plans • Download

Search 2021 Pharmacies

 


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.

 


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number for PPO Plans
1-855-479-3657

Phone Number for HMO Plans
1-844-232-2316


Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478
 

Formulary information for 2020 Arizona plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Arizona plans • Download

Search 2020 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Arizona plans •  Download

 Search 2020 Pharmacies


Learn about 2020 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 refill 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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Formulary information for 2020 Georgia plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Georgia plansDownload

Search 2020 formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

Choice PPO (Standard/Preferred Network) • Download

Search 2020 pharmacies


Learn about 2020 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 60 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 60-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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478
 

Formulary information for 2020 New Jersey plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All New Jersey plans •  Download

Search 2020 formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

PPO plans Download
HMO plans Download

Search 2020 pharmacies


Learn about 2020 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 60 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 60-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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number for PPO Plans
1-855-479-3657

Phone Number for HMO Plans
1-844-232-2316


Formulary information for 2020 Pennsylvania plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Pennsylvania plansDownload

Search 2020 formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Pennsylvania plansDownload

Search 2020 pharmacies


Learn about 2020 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 60 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 60-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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Formulary information for 2020 South Carolina plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All South Carolina plans Download

Search 2020 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All South Carolina plans Download

Search 2020 Pharmacies


Learn about 2020 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 refill 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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


 

Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478

 

Formulary information for 2020 Tennessee plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Tennessee plans Download

Search 2020 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Tennessee plans •  Download

Search 2020 Pharmacies


Learn about 2020 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 refill 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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657


Related information

For more information about the BAE policy, contact our Customer Experience Team at 1-888-778-1478
 

Formulary information for 2020 Texas plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Texas plans • Download

Search 2020 formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

Texas PPO plans (Standard/Preferred Network) •  Download

Texas HMO plans (Standard/Preferred Network) •  Download

Search 2020 pharmacies


Learn about 2020 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 60 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 60-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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

PPO Plans Phone Number
1-855-479-3657

HMO Plans Phone Number

1-844-232-2316


Formulary information for 2021 Mississippi plans

 

Find out if your drugs are covered

Clover's comprehensive formulary lists all brand name and generic drugs available for your health needs. Our formulary represents the prescription therapies believed to be necessary for a quality treatment program, and was designed by Clover in consultation with a team of healthcare providers.

Clover covers the drugs listed in our formulary as long as the drug is medically necessary and all plan rules are followed.

 

 

All Mississippi plans • Download

Search 2021 Formulary


Find a pharmacy

We partner with in-network pharmacies to provide prescription drugs to Plan members. In most cases, your prescriptions are covered only if they are filled at a network pharmacy or through our mail order pharmacy service. We will fill prescriptions at non-network pharmacies under certain circumstances described in the Evidence of Coverage.

 

All Mississippi plans • Download

 Search 2021 Pharmacies


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.


If your drug isn't included

Call our partners in medication services, CVS Caremark to discuss options or submit a Coverage Determination Form online. You can also ask your doctor if there's an acceptable alternate medication covered under our formulary.

 

Phone Number
1-855-479-3657