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It’s easy to check the prescription medications that are covered:
If your patient needs medication, you’ll want to check the preferred drug list for covered medications, step therapy requirements, quantity limits and updates.
- Prescribe a similar one that is on the list
- Get prior authorization (PA) for coverage
Other drug lists
Members can also see the list of medications covered for Diabetic supplies:
Some medications on the formulary have quantity limits. They’re marked on the formulary with the letters “QLL” and are established with the FDA-approved dosing levels for treating certain conditions.
For more info, members can visit the Kentucky Department of Medicaid Services website.
P&T decisions are made by Commissioner of the Department for Medicaid Services (DMS)
Over-the-counter (OTC) medications
Members can get coverage for OTC medications on the Over-the-Counter (OTC) Drug list.
If you have any questions, please contact MedImpact at 1-800-210-7628 (TTY: 711) from Monday-Friday 8:00 AM to 7:00 PM ET or visit their website at: http://kyportal.medimpact.com.
For more info, you can visit the Kentucky Department of Medicaid Services website at: https://chfs.ky.gov/agencies/dms/dpo/ppb/Pages/default.aspx
Getting medications and refills
If a member needs medication, you can write them a prescription for one on the Statewide PDL. Members will want to:
- Have you check that the medication is on the Statewide PDL
- Take their prescription to any Medicaid enrolled pharmacy
- Show their plan member ID card at the pharmacy
When a member needs refills, they can check their medication label to see how many refills they have. A few days before they run out of medication, they can call their pharmacy to place a refill order. If the pharmacy doesn’t have any refills left and they need more medication, they can check with their provider. The provider may want to see them before prescribing refills.
If a member takes maintenance medications for an ongoing health condition, they can get them by mail. Members can go to any mail order pharmacy contracted with the state. Contact MedImpact to assist with this request at 1-800-210-7628 (TTY: 711). The helpdesk offers 24-hour service. Members can also visit http://kyportal.medimpact.com.