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The document explains what a Drug List/formulary means, how network pharmacies and plan rules generally affect coverage, and how benefits may interact with supplemental coverage for certain Part B supplies. It also details vaccine and insulin cost messaging, notes changes since last year, and describes when formulary changes occur, including monthly updates and potential in-year coverage adjustments.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/2026-formulary-list-of-covered-drugs-drug-list-university-of-california-navitus-medicarerx/288630/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/2026-formulary-list-of-covered-drugs-drug-list-university-of-california-navitus-medicarerx/288630.png","ImageObject",442,249,{"name":88,"@type":89},"Liam","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":79},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the Navitus MedicareRx Drug List (formulary)?","Question",{"text":108,"@type":109},"It is a list of covered drugs selected by Navitus MedicareRx with healthcare providers, representing prescription therapies believed necessary for a quality treatment program.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When was this 2026 Drug List updated, and how can members get the latest version?",{"text":113,"@type":109},"The Drug List was updated on 09/26/2025, and updated information is posted monthly on the member portal or can be requested by contacting Customer Care.",{"name":115,"@type":106,"acceptedAnswer":116},"How can coverage change during the year and what types of changes may affect members?",{"text":117,"@type":109},"Most coverage changes happen on January 1, but drugs may also be added or removed during the year, moved to different cost-sharing tiers, or receive new restrictions, including immediate substitutions or removals for certain versions.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},288630,1790016255,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":32},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","NAVITUS MEDICARERX (PDP)  \n2026 FORMULARY  \n(LIST OF COVERED DRUGS, “DRUG LIST”) UNIVERSITY OF CALIFORNIA  \nPLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN  \nHPMS Approved Formulary File Submission ID 00026151 Version Number 07  \nThis Drug List was updated on 09/26/2025 . For more recent information or other questions, contact Navitus MedicareRx Customer Care at 1-833-837-4309 (TTY users call 711), available 24 hours a day, 7 days a week (except on Thanksgiving and Christmas Day) or visit our member portal at [https://memberportal.navitus.com](https://memberportal.navitus.com or ucal.us/medicaresupplement)[ or](https://memberportal.navitus.com or ucal.us/medicaresupplement)[ ](https://memberportal.navitus.com or ucal.us/medicaresupplement)[ucal.us/medicaresupplement](https://memberportal.navitus.com or ucal.us/medicaresupplement).  \no Important Message About What You Pay for Vaccines-Our plan covers most Part D vaccines at no cost to you. Call Customer Care for more information.  \no Important Message About What You Pay for Insulin-You won’t pay more than $35 for a onemonth supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.  \nNote to existing members: This Drug List has changed since last year. Please review this document to make sure that it still contains the drugs you take.  \nWhen this Drug List (Formulary) refers to “we,” “us,” “our,” “plan” or “our plan,” it means Navitus MedicareRx.  \nThis document includes a list of the drugs (Drug List) for our plan which is current as of 09/26/2025 . For an updated Drug List, please contact us. Our contact information, along with the date we last updated the Drug List, appears on the front and back cover pages.  \nYou must generally use network pharmacies to use your prescription drug benefit. Benefits, Drug List, pharmacy network, and/or copayments/coinsurance from time to time during the year.  \nThis Drug List was updated on 09/26/2025 S9701_2026_UCA_FORM_V01 .07_C  \nWhat is the Navitus MedicareRx Drug List (formulary)?  \nIn this document, we use the terms Drug List and formulary to mean the same thing. A Drug List is a list of covered drugs selected by Navitus MedicareRx in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part ofa quality treatment program. Navitus MedicareRx will generally cover the drugs listed in our Drug List if the drug is medically necessary, the prescription is filled at a Navitus MedicareRx network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.  \nSecondary coverage may be provided by your supplemental (wrap) coverage for some Part B supplies, after Medicare Part B has paid as primary. However, these Part B supplies must be included on the Drug List.  \nFor a complete listing ofall prescription drugs covered by Navitus MedicareRx, please visit our member portal at [https://memberportal.navitus.com](https://memberportal.navitus.com or ucal.us/medicaresupplement or)[ or](https://memberportal.navitus.com or ucal.us/medicaresupplement or)[ ](https://memberportal.navitus.com or ucal.us/medicaresupplement or)[ucal.us/medicaresupplement](https://memberportal.navitus.com or ucal.us/medicaresupplement or)[ or](https://memberportal.navitus.com or ucal.us/medicaresupplement or) call us. Our contact information, along with the date we last updated the Drug List, appears on the front and back cover pages.  \nCan the Drug List (formulary) change?  \nMost changes in drug coverage happen on January 1, but we may add or remove drugs on the Drug List during the year, move them to different cost-sharing tiers, or add new restrictions. We must follow the Medicare rules in making these changes. Updates to the formulary are posted monthly to our member portal at [https://memberportal.navitus.com](https://memberportal.navitus.com or ucal.us/","cbCaidvI9iUN7UAt","https://ap.wps.com/l/cbCaidvI9iUN7UAt","pdf",807370,143,"English","# Important plan information\n## Covered vaccines and insulin cost messages\n## Drug list purpose and coverage conditions\n## Can the drug list change?\n## Changes that can affect you this year","[{\"question\":\"What is the Navitus MedicareRx Drug List (formulary)?\",\"answer\":\"It is a list of covered drugs selected by Navitus MedicareRx with healthcare providers, representing prescription therapies believed necessary for a quality treatment program.\"},{\"question\":\"When was this 2026 Drug List updated, and how can members get the latest version?\",\"answer\":\"The Drug List was updated on 09/26/2025, and updated information is posted monthly on the member portal or can be requested by contacting Customer Care.\"},{\"question\":\"How can coverage change during the year and what types of changes may affect members?\",\"answer\":\"Most coverage changes happen on January 1, but drugs may also be added or removed during the year, moved to different cost-sharing tiers, or receive new restrictions, including immediate substitutions or removals for certain versions.\"}]","2026 FORMULARY - List of Covered Drugs (Drug List) - University of California - Navitus MedicareRx | PDF",1789633719]