Drug Finder

 Find what prescription drugs are covered under AlohaCare Plans.

The Formulary is a list of the drugs that we cover. It may change during the year. We may add or remove drugs from our Formulary. Generally, we will cover the drugs listed on our Formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy, and other coverage rules are followed.  

If you would like to request coverage for drugs that are not included on our formulary or require prior authorization, your doctor can:  

• Use their current electronic health record/electronic medical record (EHR/EMR) system  

• Use Surescripts 

• Use CoverMyMeds 

• Use Prompt PA (for QUEST and AlohaCare CCS only); or  

• Send us a completed request form that can be found under Pharmacy Forms on the Provider Forms page.  

• AlohaCare Advantage Plus (HMO D-SNP): Searchable | PDF | PA Criteria | ST Criteria |Machine Readable

              AlohaCare Medicare with AlohaCare QUEST Medicaid (combined coverage)

• AlohaCare Advantage (HMO D-SNP): Searchable | PDF | PA Criteria | ST Criteria |Machine Readable     

              AlohaCare Medicare (primary) with Other QUEST Medicaid (secondary)

• QUEST (Medicaid): Searchable | PDF | Machine Readable

              AlohaCare QUEST Medicaid (primary)

              Other Health Plan (primary) with AlohaCare QUEST Medicaid (secondary)

• QUEST (Medicaid) Wrap Benefit: Searchable | PDF | Machine Readable

              Other Medicare (primary) with AlohaCare QUEST Medicaid (secondary)

• AlohaCare Community Care Services (CCS): Searchable | PDF (coming soon) | Machine Readable (coming soon)

Changes to the AlohaCare Formulary

For a list of drugs that AlohaCare covers under the medical benefit plan, use our Prior Auth Lookup Tool.

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