Michigan medicaid formulary pdf

For people that need to join a health plan, michigan enrolls will send a letter with more information. Hap empowered duals hmo snp is a medicare health plan with a medicare contract and a contract with the michigan medicaid program. Extends the requirements for formulary change as indicated in the cms announcement of calendar year cy 20 medicare. Humana medical plan formulary spanish, pdf opens new window.

Hap empowered mi health link medicaremedicaid plan 2020 list. Uphp mi health link is a health plan that contracts with both medicare and michigan medicaid to provide benefits of both programs to enrollees. The goal of the upper peninsula health plan uphp is to provide our members rational, clinically appropriate, and cost effective pharmaceutical care. The common formulary includes drugs that are covered as a pharmacy benefit. Effective 9302016, meridianhealth will be transitioning to michigans common drug formulary. Find your formulary and drug search tool to find information on the drugs your plan covers.

Michigan department of health and human services preferred drug list effective 04142020 preferred agents do not require prior authorization, except as noted in the chart at the bottom of the page 1 prior authorization not required for beneficiaries under the age of 12. Searchable formulary amerihealth caritas vip care plus. District of columbia department of health care finance pharmacy preferred drug list pdl effective march 19th, 2020 nonpreferred medications require prior authorization page 3 of 21 antiinfectives drug class preferred requires prior authorization. Humana medical plan formulary english, pdf opens new window. The unitedhealthcare community plan specialists can answer questions and help you enroll.

Nc medicaid and health choice preferred drug list pdl effective dec. Michigan complete health medicare medicaid plan 2019 list of covered drugs formulary introduction this document is called the list of covered drugs also known as the drug list. Jul 1, 2018 effective 712018 plans all utilize the standard ncpdp reject code for any gender magellan medicaid administration for reimbursement. View the 2020 formulary english pdf opens in new window spanish pdf opens in new window formulary updates. Mar 1, 2017 in order to streamline drug coverage policies for medicaid and healthy the common formulary includes drugs that are covered as a mi 1540 pharmacy state of michigan. Michigan department of health and human services preferred. Medicare formulary drug list michigan health insurance hap. Cy 2015 marketing guidance for michigan medicaremedicaid plans. Please see the link below for changes to the formulary for patients with florida medicaid coverage. This is known as the michigan medicaid managed care common formulary. Amerihealth caritas vip care plus medicare medicaid plan is a health plan that contracts with both medicare and michigan medicaid to provide benefits of both programs to enrollees.

In order to streamline drug coverage policies for medicaid and healthy michigan plan members and providers, the michigan department of health and human services mdhhs has created a formulary that is common across all contracted. Health alliance plan hap has hmo, hmopos, ppo plans with medicare contracts. Effective 9302016, meridianhealth will be transitioning to michigan s common drug formulary. Documentation of positive response to therapy required. Compare 2020 michigan plan details with the 2019 plans. The michigan premier plan formulary documents can be found below. It tells you which prescription drugs and overthecounter drugs are covered by michigan complete health. G3245 beecher road flint, michigan 48532 tel 8883270671 fax 8335408648 mhp20190104 rev. Fax signed forms to aetna better health of michigan at 18557992551. Effective 9302016, meridianhealth will be transitioning to michigans. The michigan department of health and human services has worked with its health plan partners to create a list of drugs that all. For more recent information or other questions, please contact. Mdhhs medicaid health plan pharmacy benefit michigan. Medicaid health plan common formulary contents michigan.

For more recent information or other questions, please contact hap empowered mi health link medicare medicaid plan customer service at 888 6540706 tty. Check your summary of benefits to ensure this formulary is associated with your plan prior to using your prescription drug benefit. Floridas agency for health care administration ahca regularly updates the florida medicaid preferred drug list. The public may submit comments on the drugs included or not included on the common. Formulary product alternative list april 2020 ql quantity limitations st step therapy indicates medication is covered generically non. Some drugs on the medicaid formulary are subject to one or both types of prior. Public comment on mdhhs medicaid health plan common. Lean national 5 mapd formulary changes, pdf opens new window. Medicaid and healthy michigan plan list of covered drugs please read. List of covered drugs formulary 2020 vip care plus. Unitedhealthcare offersunitedhealthcare dual complete hmo dsnp h224700 plans for michigan and eligible counties. In addition, some vitamins and minerals and home health supply products are also available as a pharmacy benefit. For more recent information or other questions, please contact hap empowered mi health link medicaremedicaid plan customer service at 888 6540706 tty. The list of covered drugs formulary is a list of drugs that members can get in upper peninsula health plan uphp mi health link medicaremedicaid plan.

Mar 1, 2017 magellan medicaid administration for reimbursement. Brand named drugs are capitalized, generic drugs start with lower case letters. Humana premier rx plan formulary changes, pdf opens new window. This dru g formulary lists covered generic and brandname drugs covered under our managed medicaid plans, medisource and child health plus. People under feeforservice will use the mihealth card to receive services. See all michigan national and regional medicare part d pdp plan details copayscoinsurance, plan ratings, formulary, enrollment figures, etc. Molina healthcare of michigan preferred drug list formulary is the. Key generic available ag age limits f females only m males only otc over the counter p preventive pa prior authorization ql quantity limit sp specialty pharmacy.

Drugsformulary aetna better healthsm premier plan aetna better health premier plan medicaremedicaid plan is a health plan that contracts with medicare and michigan medicaid to provide benefits of both programs to enrollees. Drugs formulary aetna better healthsm premier plan aetna better health premier plan medicare medicaid plan is a health plan that contracts with medicare and michigan medicaid to provide benefits of both programs to enrollees. Public comment on mdhhs medicaid health plan common formulary. Florida medicaid preferred drug list updated 05 062020. The list includes prescription and nonprescription medicines. We are pleased to provide this formulary as a useful reference and informational tool. Michigan medicaid medication formulary medicare add. It tells you which prescription drugs, overthecounter drugs and items are covered by amerihealth caritas vip care plus. These formularies include all legend and overthecounter drugs. The 2020 molina healthcare of michigan preferred drug list formulary is the michigan medicaid managed care common formulary.

Michigan complete health medicare medicaid plan 2020. For more recent information or other questions, please contact us, medicare plus blue group ppo or. Formulary provider meridian health plan of michigan. Michigan complete health medicaremedicaid plan 2019 list of covered drugs formulary introduction this document is called the list of covered drugs also known as the drug list. The folowings tab will be activated by enter or space bar. Super national 5 mapd formulary changes, pdf opens new. Montana medicaid preferred drug list pdl revised 8218 indicates a generic is available without prior authorization this list may not include all available generic formulations listed specifically by name note. It tells you which prescription drugs and overthecounter drugs and items are covered by michigan complete health. State and specialty pharmacy drug reimbursement rates effective 512020 influenza vaccine procedure codes reimbursable to outpatient pharmacies for wisconsin medicaid and badgercare plus feeforservice and managed care members november 14, 2014. Documented failure of two formulary steroids, at least one must be high pr very high potency. Preferred drug list blue cross complete michigan medicaid. The michigan department of health and human services has worked with its health plan partners to create a list of drugs that all medicaid health plans must cover. Open the attached list and use the adobe acrobat search tool to locate specific drugs by name or hic3 therapeutic class.

Ingredient cost for all drugs for retail pharmacies, rural, mail order, specialty, government, institutional and long term. List of covered drugs michigan michigan complete health. Cvs caremark value formulary effective as of 04012020. Formulary 20163, version 14 2020 standard comprehensive formulary list of covered drugs please read. Jul 25, 2019 michigan medicaid authorization lookup note. This list is called the michigan medicaid managed care common formulary. Oct 22, 2014 medicaremedicaid plans mmps participating in the michigan capitated financial. Environmental health 705 n zeeb road ann arbor, mi 48103 phone. View the formulary updates pdf opens in new window. Medicaid health plan common formulary state of michigan. Effective 412020 medicaid health plan common formulary changes effective april 1, 2020, continued drug class drug name new status antineoplastic thalidomide analogs pomalyst 1mg, 2mg, 3mg, 4mg capsule covered on formulary with prior authorization. It tells you which prescription drugs and overthecounter drugs are covered by. Florida medicaid preferred drug list updated 05062020 the florida medicaid preferred drug list pdl is subject to revision following consideration and recommendations by the pharmaceutical and therapeutics pt committee and the agency for health care administration. Michigan complete health medicaremedicaid plan 2020 list.

The quarterly pt committee meeting was held on december, 2019. Most drugs are identified as preferred or nonpreferred. This webpage is designed to provide easy access for members and providers looking for information on the drugs and supplies covered by michigan medicaid health plans. For more recent information or other questions, contact us at.

List of drugs covered under michigan medicaid your green mihealth card note. A formulary is a list of covered drugs selected by medicare plus blue group ppo and prescription blue group pdp in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Michigan unitedhealthcare community plan unitedhealthcare. In addition to this list, you can use our online search tool. This plan gives you a choice of doctors and hospitals. Michigan 2020 unitedhealthcare dual complete hmo dsnp. Approved but not implemented implementation date is scheduled no later than quarter 2 of 2018 with retrobilling back to april 1st, 2017. Molina healthcare of michigan preferred drug list formulary. The michigan department of health and human services mdhhs is soliciting comments from the public on the michigan medicaid health plan common formulary. The uphp medicaidcshcshealthy michigan formularies are aligned with the mdhhs michigan department of health and human services common formulary for all contracted health plans in the state of michigan per the comprehensive health plan contract. Jul 17, 2019 the michigan department of health and human services mdhhs is soliciting comments from the public on the michigan medicaid health plan common formulary. Michigan complete health medicaremedicaid plan 2020.

Hap empowered mi health link medicaremedicaid plan 2020. Hap empowered mi health link medicaremedicaid plan. This document contains information about the drugs we cover in this plan. Show 2020 medicare part d plans for a different state. The common formulary applies to pharmacy claims paid by medicaid managed care organizations it will not apply to claims paid through feeforservice.