Prescription Drugs

presdrugs

The drug formulary is a list of covered drugs. Molina Healthcare will generally cover any prescription drug listed in our formulary as long as:

  • The drug is medically necessary.
  • The prescription is filled at a Molina Healthcare network pharmacy and other plan rules are followed.


Drug Formulary

To view the Molina Healthcare of Illinois Drug Formulary for your plan, please click below.

icon PDF 2024 Comprehensive Formulary 

icon PDF 2025 Comprehensive Formulary 

icon PDF Drug Formulary Updates


Drug Formulary Search

2024 Formulary Search

2025 Formulary Search

Please note: Members can contact the plan for a printed copy of the most recent list of drugs or view the link below. You can contact our Pharmacy team at (877) 901-8181, TTY 711, Monday - Sunday, 8:00 a.m. to 8:00 p.m. local time.


Can the Formulary Change?

  • We may add or remove drugs from the formulary during the year. View icon PDF Drug Formulary Updates.
  • Changes in the formulary may affect which drugs are covered and how much you will pay when filling your prescription.
  • If we remove drugs from the formulary, or add prior authorizations, quantity limits and/or step therapy restrictions on a drug, and you are taking the drug affected
  • by the change, we will notify you of the change at least 60 days before the date that the change becomes effective.
  • If a drug is removed from our formulary because the drug has been recalled from the market, we will not give 60 days notice before removing the drug from the formulary. Instead, we will remove the drug from our formulary immediately and notify members about the change as soon as possible.


Learn More About Your Pharmacy Benefits by Clicking on an Option Below:

Medication Therapy Management Program

icon PDF Drug Formulary Updates

icon PDF 2024 Prior Authorization Grid

icon PDF 2024 Step Therapy Grid

icon PDF 2024 Medicare Part D Drug (J-Code) Step Therapy

icon PDF 2025 Prior Authorization Grid

icon PDF 2025 Step Therapy Grid


icon PDF 2024 Exceptions for Out-of-Network (OON) Coverage
icon PDF 2025 Exceptions for Out-of-Network (OON) Coverage
Information on when Molina Healthcare will reimburse members for coverage charges incurred at out-of-network pharmacies.
 
icon PDF  2024 Transition Policy
Information for new members in our plan who are taking drugs that aren't on our formulary or that are subject to certain restrictions.
 
icon PDF 2024 Medication Safety Policy
Managing your medications is important to us!
Molina Healthcare has established quality assurance measures and systems in order to make sure that medications are used in a safe and effective manner.
 

Click here to view Prescription Drug forms


How do members get care?

 

For more information, you can call Member Services.

 

Plan Materials

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*Printed copies of information posted on our website are available upon request.
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