Buckeye Health Plan is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Buckeye Health Plan members. Buckeye Health Plan covers prescription medications and certain over-the-counter medications with a written order from a Buckeye Health Plan provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.

Unified Preferred Drug List (PDL)

TThe 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) and the single Pharmacy Benefit Manager (PBM), Gainwell Technologies, has created and maintains a unified preferred drug list.  All Ohio Medicaid MCPs follow the PDL which means the same medications are preferred and the same prior authorization criteria is used This unified list can be found on Gainwell’s website. The PDL identifies preferred medications, non-preferred medications, which medications require prior authorization, and any other limits that may apply to certain medications. Providers may refer to the ODM Pharmacy website under “Drug Coverage” for more information. Please note that the ODM website is to only be used as a reference and we encourage our providers to refer to the PDL document on Gainwell’s website.

Providers can contact Gainwell with questions about the PDL or the prior authorization process at 833-491-0344.


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