HAP CareSource MI Coordinated Health List of Covered Drugs (Drug List)
This document is the Plan's List of Covered Drugs (Drug List) for HAP CareSource MI Coordinated Health describing covered drugs, restrictions (prior authorization, quantity limits, step therapy), member rights (exceptions, transitions), pharmacy supply options (mail-order, retail), and FAQs. It applies to plan members using network pharmacies and explains rules for Medicare and Michigan Medicaid covered drugs.
No material clinical or coverage changes — this excerpt is an updated segment of the drug list showing update dates (last updated 03/13/2026 and document updated 04/01/2026).
Document version 9, Formulary ID 00026143; Drug List updated on 04/01/2026; some table portions note last updated 03/13/2026.
Coverage Summary
General coverage / member eligibility
This Drug List covers medications and certain OTC products available to HAP CareSource MI Coordinated Health members. Covered drugs must be medically necessary, prescribed by a licensed provider, and dispensed at a HAP CareSource network pharmacy. The plan follows Medicare and Michigan Medicaid rules; some products may have special pharmacy network, quantity, prior authorization, step therapy, or other utilization controls. Changes to the Drug List (adds/removals or rule changes) follow federal/state requirements and members may request exceptions or transition supplies when rules change.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.