It’s important to Buckeye Health Plan that our members receive drug therapy that is appropriate, high quality and cost effective. We work hard to ensure you have access to safe and effective medications that are medically proven to help you get healthy and stay healthy.
Unified Preferred Drug List (PDL)
The Preferred Drug List (PDL) is the list of drugs covered by Buckeye Health Plan. The Ohio Department of Medicaid, in partnership with the Medicaid managed care plans (MCPs), is moving toward creating a unified preferred drug list (PDL). Beginning January 1, 2020, all Ohio Medicaid MCPs will prefer the same medications and use the same prior authorization criteria for the majority of drug categories. This unified list (The Preferred Drug List (PDL) Effective 04.01.20) (PDF) of drugs will help you know which drugs are covered with or without prior approval. Prior approval is also called prior authorization. To find specific drugs and details on coverage, use our Searchable PDL.
If a prescription drug you take is no longer preferred, you will be notified by your doctor, MCP or pharmacy. If a prescription drug you take is no longer preferred, we will send you a letter in November 2019. The letter will tell you which of your current drugs will need prior approval. You may need to change your current drug(s) or get prior approval from your prescriber to stay on your current drug(s). If you receive a letter in the mail from your Buckeye Health Plan, make sure to review the letter carefully. You should discuss this information with your prescriber at your next visit or call your prescriber at your earliest convenience. However, if you go to the pharmacy to refill your prescription before your next visit, you might be told that your drug requires prior approval from your prescriber. We will work with your prescriber to cover a drug that meets your needs. You will not lose drug coverage. Please note that you will also continue to use the same Medicaid ID.
If you have questions or problems with your prescription, call member services by dialing the toll-free number 1-866-246-4358 on your Medicaid ID card.
Buckeye Health Plan covers certain prescription drugs and over-the-counter drugs when prescribed by a Buckeye Health Plan provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage or maximum quantities.
The Preferred Drug List (PDL) (PDF) is the list of drugs covered by Buckeye Health Plan. Buckeye Health Plan works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. The PDL applies to drugs you receive at retail pharmacies. The Buckeye Health Plan PDL is continually evaluated by the Pharmacy and Therapeutics Committee to promote the appropriate and cost-effective use of medications.
To find a pharmacy that is in the Buckeye Health Plan network, you can use the Find a Provider tool. Type in your city or zip code. Then click Update. Choose Other and type the name of your pharmacy. You can also select the pharmacy type in the Select Specialty area. Only those pharmacies in the Buckeye Health Plan network are listed.