Prescription medications are covered when:
- They are ordered by your provider or another doctor treating you and the drug is listed on the Molina Healthcare Drug List (Formulary).
- The Drug List (Formulary) is Molina Healthcare’s list of approved drugs that doctors can order for you.
- They are ordered or given while you are in an emergency room or hospital.
- They are given while you are in a rest home, nursing home or convalescent hospital and they are ordered by a plan doctor for a covered service and you got them through a pharmacy that is in the Molina Pharmacy Network.
Generic drugs have the same ingredients as brand name drugs. To be FDA (government) approved, the generic drug must have the same active ingredient, strength and dosage (formulation) as the brand name drug.
- If your doctor orders a brand name drug and there is a generic available, Molina Healthcare will cover the generic medication. If your doctor says that you must have the brand name drug instead of the generic, he/she must submit a Prior Authorization Form to Molina Healthcare’s Pharmacy Department.
It tells you what you need to know about your Molina Healthcare of Idaho Medicaid Plus Health Plan. Read here.
How do members get care?
Call Member Services at (844) 809-8445 Monday through Friday 8:00 a.m. to 8:00 p.m. Mountain Time (TTY: 711).
- You need to ask about a drug.
- You have trouble getting a prescription filled at the pharmacy (please do not pay for the prescription).
- Prescriptions are covered through Molina Healthcare’s contracted pharmacies within Idaho. Prescriptions are covered outside of the state of Idaho (out of area) for emergency or urgent services only.
- You need an interpreter to communicate with the pharmacy about getting your medication.
- When you have an emergency and need drugs, Molina Healthcare will provide you with up to a 72-hour supply of the drug.