State of Georgia government websites and email systems use “georgia.gov” or “ga.gov” at the end of the address. New York Medicaid Medicaid-Approved Preferred Drug List Effective December 1, 2020 Legend In each class, drugs are listed alphabetically by either brand name or generic name. Montana Medicaid Preferred Drug List (PDL) Revised October 28, 2020 *Indicates a generic is available without prior authorization This list may not include all available generic formulations listed specifically by name Note: Brand Nebraska Medicaid Preferred Drug List with Prior Authorization Criteria PDL Updated June 1, 2020 Highlights indicated change from previous posting For the most up to date list of covered drugs consult the Drug Lookup North Carolina Medicaid and Health Choice Preferred Drug List (PDL) Effective: February 1, 2020 T rial and failure of two Preferred drugs are required unless only one Preferred option is listed or is … Brand name drug… 9. This list is updated regularly. Illinois Medicaid Preferred Drug List Effective April 1, 2020 The Preferred Drug List (PDL) has products listed in groups by drug class, drug name, dosage form, and PDL status Multi-source drugs are listed by both brand and generic Prescribers may request an override for non-preferred drugs by calling the Magellan Medicaid Administration (MMA) Help Desk at: Toll Free 1-800-424-7895 and choose the PDL option. Medicaid-Approved Preferred Drug List Effective December 1, 20 20 Legend In each class, drugs are listed alphabetically by either brand name or generic name. Use our Medicaid Preferred Drug List (Link) to find more information on the drugs that are covered. North Carolina Medicaid and Health Choice Preferred Drug List (PDL) Effective: September 1, 2020 T rial and failure of two Preferred drugs are required unless only one Preferred option is listed or is … The .gov means it’s official. Idaho Medicaid Preferred Drug List with Prior Authorization Criteria NOTE: The links to the PA forms are currently not working. Florida Medicaid Preferred Drug List (effective 10-01-2020) The Florida Medicaid Preferred Drug List (PDL) is subject to revision following consideration and recommendations by the Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration. Virginia Medicaid’s Preferred Drug List (PDL)/Common Core Formulary 7/1/20 1 | P a g e Virginia Medicaid’s Pharmacy Benefits Management System Phone: 800-932-6648 Fax: 800-932-6651 General Information: • Virginia Medicaid’s Preferred Drug List (PDL)/ Common Core Formulary only includes select drug classes, other classes will pay such as but not Oregon Health Plan Preferred Drug List, a list of the most cost-effective drugs to prescribe for fee-for-service members. Virginia Preferred * Note that agents not listed on PDL may be considered non-preferred Drug List (PDL) / Common Core Formulary QuickList Effective January 1, 2020 General Information: • Virginia Medicaid’s Preferred Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List - Quick Reference Revised 3/30/2020 (Effective 04/01/2020) KEY: • SCN = Wisconsin SeniorCare does not cover over-the-counter drugs. For more up-to-date information or if you have any questions, please call Customer Service at: Toll-free 1-844-855-9776, TTY 711 8am-8pm: 7 Days Oct-Mar; M-F Apr-Sept www.UHCCommunityPlan.com Formulary ID Number 00020047 ... united healthcare community … R x MeridianComplete (Medicare-Medicaid Plan) 2020 List of Covered Drugs (Formulary) Formulary ID: 20516Version Number: 24 This formulary was updated on 1/24/2020. Cookies are used to improve the use of our website and analytic purposes. You may still be able to get drugs not on the Preferred Drug List. Preferred Drug List (PDL) - November 9, 2020 Please refer to the Additional Therapeutic Criteria Chart, Dosage Limitation List (red font indicates quantity/dosage limits apply) , and the Wyoming Medicaid Please note that starting the requested drug, including a non-preferred drug, prior to a PA request being reviewed and approved, through either inpatient use, by using office “samples”, or by any other means, does not necessitate Medicaid approval of the PA request. Details: 20201 COMPLETE DRUG LIST (FORMULARY) Important Notes: This document has information about the drugs covered by this plan. LA Medicaid Preferred Drug List (PDL)/Non-Preferred Drug List (NPDL) Effective Date: October 1, 2019 Additional Point-of-Sale (POS) Edits May Apply Page | 5 Descriptive Therapeutic Class Drugs on PDL Drugs on NPDL which Require Prior Authorization (PA) The Preferred Drug List below was updated from the September 18, 2020 P&T Committee meeting.Open the attached list and use the Adobe Acrobat search tool to locate specific drugs by name or HIC3 therapeutic We use cookies on our website. 2021 South Carolina Medicaid Comprehensive Preferred Drug List (List of Covered Drugs) WellCare of South Carolina 00 Please read: This document contains information about the drugs we cover in this plan. If you learn that Health Plan of Nevada Medicaid does not prefer the drug, you Prescription Drug List - Essential - Effective January 1, 2020 Prescription Drug List - Essential - Colorado Doctor’s Plan - Effective July 1, 2019 Community Plan / Medicaid : Visit Health Plans by State > Select State > select "Pharmacy Resources … Local, state, and federal government websites often end in .gov. Preferred Drug List (PDL) (PDF) Division of Medicaid Preferred Drug List Changes - Effective 10/1/2020 (PDF) Universal Preferred Drug List Magnolia uses a list of preferred and non-preferred medications called the 866-912-6285 (). The preferred drug list is arranged by drug therapeutic class and contains a subset of many, but not all, drugs on the Medicaid formulary. Department of Vermont Health Access 280 State Drive Waterbury, Vermont 05671-1010 Phone: 802-879-5900 Fax: 802-241-0260 Department Contact List for customer service, program telephone and fax numbers, and staff email Preferred Drug List (PDL) (PDF) Division of Medicaid Preferred Drug List Changes - Effective 10/1/2020 (PDF) Division of Medicaid For more recent information orother Before sharing sensitive or Most drugs are identified as “preferred” or “non-preferred”. What if the drug you want to take is not on the Preferred Drug List?If you don’t see your drug on the Preferred Drug List, call Member Services and ask about it. To get drugs not on the Preferred Drug List, your provider will need to get prior authorization from Health First Colorado. Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Revised 08/17/2020 (Effective 08/01/2020) Page 3 of 13 Brand Before Generic Drug Refer to topic #20077 Monthly Changes to Please note that the LA Medicaid Preferred Drug List (PDL)/Non-Preferred Drug List (NPDL) Effective Date: July 1, 2020 Additional Point-of-Sale (POS) Edits May Apply Drugs highlighted …

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