Important Change in the Coverage of Prescription Drugs for Ohio Medicaid Consumers
Starting February 1, 2010, Ohio Medicaid will pay for your prescription drugs and some prescription medical supplies instead of your Medicaid managed care plan. This change affects everyone who gets health care through an Ohio Medicaid managed care plan.
Ohio Medicaid pays for prescription drugs and the following prescription medical supplies when dispensed at the pharmacy:
- diabetic supplies
- inhaler spacers
- peak flow meters
- syringes
- needles
- alcohol wipes
- condoms
If you have a question, or if you have a problem with your prescription drug coverage or the pharmacy, call the Ohio Medicaid Consumer Hotline at 800-324-8680 or TTY 800-292-3572. The Hotline is open from 7:00 a.m. – 8:00 p.m. Monday-Friday and 8:00 a.m. – 5:00 p.m. Saturday.
Further information on prescription drugs is available on the Ohio Department of Job and Family Services website at http://jfs.ohio.gov/ohp/bhpp/meddrug.stm.
Medical supplies, other than those listed above, are covered by Molina Healthcare. For a list of providers contracted with Molina Healthcare to provide medical supplies, click on the Find a Provider link at the top of the page and select Suppliers.
If you have a question about the coverage of medical supplies, call Molina Healthcare member services at 800-642-4168 (TTY for the hearing impaired 800-750-0750 or 711).
Drugs that are given to you in a provider setting are covered by Molina Healthcare. Provider settings are a:
- physician office
- hospital
- outpatient department
- clinic
- dialysis center
- infusion center
Some drugs given to you in a provider setting require prior authorization. Molina Healthcare may require that your doctor submit information to Molina Healthcare to explain why a specific medication is needed. The request must be approved before you can get the medication.
Molina Healthcare will make a decision and respond to your doctor within 24 hours of the request. If the request is approved, we will inform your doctor. If a request is denied, a letter will be sent to you and your doctor explaining the reason for the denial, how you can appeal our decision and your right to a state hearing.
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