Welcome to the Ohio Medicaid Pharmacy Program

The Ohio Medicaid drug program is a federal and state supported program that provides prescription drug coverage to eligible recipients. The Ohio Department of Medicaid (ODM) administers the program which encompasses approximately 46,000 line items of drugs from nearly 700 different therapeutic categories. Fee-for-Service pharmacy claims are processed by ODM’s contracted pharmacy benefits administrator (PBA) in an online, real-time environment which allows the dispensing pharmacist access to the terms of coverage. In the event a particular product is not approved, the dispensing pharmacist can notify the prescriber of possible alternatives. The prescriber may choose an alternative product or may call a designated toll-free number to request prior authorization (PA) for the product originally prescribed.

ODM has implemented a Unified Preferred Drug List (UPDL) to ensure quality patient care while maintaining a financially responsible program. Additional UPDL information is available under the Unified PDL tab of this website.

DISCLAIMER: Beginning October 1, 2022, the prescription drug coverage for members of Medicaid Managed Care Plans (MCPs) is the responsibility of the Single Pharmacy Benefit Manager (SPBM) and the information available on this page will not apply to MCP members. For more information about Medicaid MCPs, please visit the Managed Care’s web page or refer to the MyCare Ohio and MCP Pharmacy Reference Guide. For more information on the SPBM, please visit the Home page.

Have questions? If you have a question or need assistance regarding the Ohio Medicaid Pharmacy program, please visit our help page for more information