Your New York Medicaid drug coverage

How the drug list works

As of April 1, 2023, prescriptions will not be covered by Molina Healthcare of New York, Inc. They will be covered by Medicaid NYRx, the Medicaid pharmacy program. 

Most pharmacies in New York State take the Medicaid NYRx pharmacy program. If your pharmacy does not take Medicaid, you may: 

• Ask your doctor to send a new prescription to a pharmacy that takes Medicaid NYRx pharmacy program, or 
• Ask your pharmacist to transfer a refill to a pharmacy that takes Medicaid NYRx pharmacy program, or 
• Locate a pharmacy that takes Medicaid NYRx using the pharmacy look up tool.

You will need to show the pharmacist either your Medicaid Card or your Health Plan Card. This will tell them your Client Identification Number (CIN). 

Medicaid NYRx has a list of covered drugs. Over-the-counter drugs and most drugs are on the list.  You can see the Medicaid Pharmacy List.

• Some drugs need prior approval before they can be filled. This list will tell you if a drug needs prior approval.  Your doctor will call to get prior approval. 
• Medicaid NYRx pharmacy plan also has a preferred drug list. View the Preferred Drug List.
• If you need a non-preferred drug, please contact your pharmacist or doctor so that they can get approval for you to get this drug. 

Your Medicaid copayment will stay the same. It may change only if your medicine is considered preferred or nonpreferred. 

Your pharmacy benefit also covers certain supplies: 

• View the list of covered supplies.
• View the list of preferred diabetic meters and test strips.

Single Statewide Medication Assisted Treatment (MAT) Formulary

• New York State covers a list of medicines for opioid overdose reversal and opioid dependence treatment. The list applies to all Medicaid Managed Care and Medicaid Fee for Service members. 
• All Medicaid members will follow the same list of preferred medicines and coverage rules. 
• View the MAT Formulary.