The 2026 Wellcare Value Script (PDP) formulary is currently active. Since formularies can vary slightly by state, the most accurate way to check coverage is through the official Wellcare tool.
1. How to View the Official 2026 Drug List
You can view the full PDF or search for specific medications using these official tools:
Online Drug Search Tool: Wellcare 2026 Pharmacy Search
Select “Value Script” if asked for the plan name.
PDF Download: The base formulary ID for the 2026 Value Script plan is often listed as Formulary ID 26195.
You can typically find the specific PDF for your region by going to Wellcare.com/PDP, selecting the state, and clicking “Pharmacy” > “Drug List (Formulary).”
2. Key Formulary Details for 2026
Tier 1 (Preferred Generic): Most plans offer a $0 copay for Tier 1 drugs when filled at a preferred retail pharmacy or via express mail order.
Insulin Cap: The plan maintains the $35/month cap for covered insulin products (per the Inflation Reduction Act), regardless of the deductible status.
Major Brand Changes:
Humira: There has been a significant shift toward biosimilars. Coverage for brand-name Humira may be reduced or removed in favor of biosimilars like Cyltezo, Yuflyma, or Hyrimoz.
Inhalers: Check for shifts between brand names (like Symbicort or Advair) and their authorized generics, as these often rotate tiers annually.
3. Understanding the Tiers
The Value Script plan generally uses a 6-Tier system for 2026:
Tier 1: Preferred Generic (Lowest cost, often $0)
Tier 2: Generic
Tier 3: Preferred Brand (Higher copay)
Tier 4: Non-Preferred Drug (High coinsurance, often 40-50%)
Tier 5: Specialty Tier (Highest cost, typically 25-33% coinsurance)
Tier 6: Select Care Drugs (Specific grouping for certain conditions)
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