Prescriptions

Medicaid provides a pharmacy benefit as part of it's package of covered services under all of it's programs. If you have a Medicaid health plan, your plan may pay for your pharmacy benefits. Not all drugs are covered, even with a doctor's prescription. Generic brands are covered by Medicaid. If there is a not a generic brand for the drug you need, you may get the name brand.

Beginning July 2009, medications that are not on the Medicaid Preferred Drug List (PDL) will need to be approved by Medicaid before your pharmacy can give them to you. Check with your doctor or pharmacist.

The number of prescriptions Medicaid will pay for each month may be limited by your Medicaid program.
  • Medicaid will review your medical history to see if you need more than the allowed prescriptions per month.
  • Over-the Counter drugs will count as part of your allowed prescriptions. Over-the-Counter List

 

Medicare and Medicaid Prescriptions.
If you have or are eligible for Medicare, please talk to your HPR with questions you have about Prescription coverage. Medicare eligible clients have different prescription benefits than clients who are not eligible for Medicare. (If you are eligible for the benefits, you must apply for them.) You must be enrolled in a private Medicare approved Prescription Drug Plan (PDP) to receive most of your prescription benefits.

The only pharamcy benefits paid by Medicaid for Medicare eligible persons are:

  • Some cough and cold medications
  • Medicaid covered over-the-counter medication prescribed by your doctor.