Your Iowa Medicaid drug coverage

Your state’s Drug List shows drugs your Medicaid plan covers. You can get drugs that are:

• Listed on your state’s Drug List (also called a PDL, RDL or formulary).
• Prescribed by a doctor who works with your state program.
• Filled at a Pharmacy that works with your state program.

Some drugs may have rules, like:

• Age limits
• Limits on how much you can get
• Limits on how soon you can fill the drug again
• The generic or similar version must be used
• You must try one drug before another (preferred drugs)
• Prior authorization (your doctor must ask for approval first)

You do not pay for covered drugs.

If you also have Medicare, you must have Part D coverage. Medicaid will not cover copays for Medicare Part D drugs. The list of drugs that will be covered under your Medicaid Plan when you also have Medicare can be found here: Part D Excluded Drugs 06-14-23.pdf

If you need help, call Member Services at (844) 236-0894 [TTY: 711]. Hours of operation: Monday through Friday, 7:30 a.m. to 6:00 p.m. local time.

Some medications require a 90-day mandatory supply. The list can be found here: 90-day-supply-list-effective

Some Over-The-Counter (OTC) drugs are covered. The list can be found here: otc-drug list

Vaccinations are only covered under the medical benefit.