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Prescription Drug Coverage

The PACE program provides prescription drugs and certain over-the counter medications for all members. Your care team works with you and your physician to be sure you are taking the right medications to meet your needs. Your team reviews your medications periodically and makes certain that medications can be taken together safely.

If you have Medicare, your prescription drug coverage is through Medicare Part D. If you have Medicaid only, your prescription drug coverage is through Wisconsin Medicaid. All PACE members have the same prescription drug coverage and benefits.

List of Covered Drugs (Formulary) The formulary explains what prescription drugs are covered by the plan. It also tells you if there are any rules that limit coverage of a drug. Lastly, it includes the over-the-counter medications that are covered by Medicaid when ordered by a physician or nurse practitioner.

Coverage Limits

Some covered drugs have limits or conditions for coverage. The following documents explain the limits and conditions:

Part D Formulary Transition Policy The Part D Formulary Transition Policy tells you how we will help if your current prescription drug is not on the Community Care formulary or if it is taken off of the formulary after you have become a member.

Pharmacy Directory

The pharmacies in our network are listed in your provider directory. In addition, you can easily find a network pharmacy in your area by using our online pharmacy directory.


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