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 49,000 line items of drugs from nearly 700 different therapeutic categories. Pharmacy claims are processed by ODM’s contracted pharmacy benefits manager (PBM) in an online, real-time environment which allows the dispensing pharmacist access to the terms of coverage. In the event a particular drug is not approved, the dispensing pharmacist can notify the prescribing physician of possible alternatives. The prescribing physician 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, 2011, the prescription drug coverage for members of Medicaid Managed Care Plans (MCPs) is the responsibility of the MCP and the information available on this page will not apply to MCP enrollees. 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.
Have questions? If you have a question or need assistance regarding the Ohio Medicaid Pharmacy program, please visit our help page for more information