Pharmacy

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)

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, Preferred Drug List Effective 04.01.2023 (PDF), of drugs will help you know which drugs are covered with or without prior approval. Prior approval is also called prior authorization. 

Thank you in advance for your cooperation. 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 use Preferred Drug List Effective 04.01.2023 (PDF).

Throughout the course of 2020, prescribers may need to transition certain patients from their current medication(s) or complete a prior authorization for the patient to stay on his/her current medication(s). As a reminder, here is our Prior Authorization Fax Number: Prior Authorization Fax Number: 877-386-4695.

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