LiveWell Covered Drugs (Formulary & Medication)

What is a formulary?

A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at our network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

View the Searchable Formulary

Updated 12/1/2022| Formulary  ID 22369, Version Number 19

Download a printable comprehensive formulary

The comprehensive formulary includes a list of the drugs (formulary) for our plan.  For more recent information or other questions, please contact our Pharmacy Benefit Manager, Elixir for AgeWell New York Member Services at 1-844-782-7670 or for TTY users, 1-800-662-1220, 7 days a week 24 hours a day or visit

Updated 12/1/2022 Formulary  ID 22369, Version Number 19

Prior Authorizationopens PDF file  Quantity Limitsopens PDF file  Step Therapyopens PDF file  Addendumopens PDF file

Request a Formulary:

If you would like to request a printed hard copy Formulary mailed to your home, please call Member Services at 1-866-237-3210, email your request or fill out the request form below.

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The formulary and/or pharmacy network may change at any time. You will receive notice when necessary.