Members of Molina Healthcare have no co-pays or out-of-pocket costs for covered prescription medications.
Prescription medications are covered when:
- They are ordered by your provider or another provider treating you or your child and the drug is listed on the Molina Healthcare Preferred Drug List (PDL).
- The PDL is Molina Healthcare’s list of approved drugs that providers 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 provider for a covered service and you got them through a pharmacy that is in the Molina Pharmacy Network.
- They are prescribed by a primary care provider (PCP) or other provider whose services do not require an approval.
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 provider orders a brand name drug and there is a generic available, Molina Healthcare will cover the generic medication. If your provider says that you must have the brand name drug instead of the generic, he/she must submit a prior authorization request form to Molina Healthcare’s Pharmacy Department explaining why the preferred medicine will not work for you. We review prior authorizations on an individual basis and consider your needs.
- Medications that require Prior Authorization can be found on the Molina Healthcare Prior Authorization (PA) List.
It tells you what you need to know about your Molina Healthcare of Ohio Medicaid Health Plan. Read more.
How do members get care?
Call Member Services at (800) 642-4168, for hearing impaired TTY/Ohio Relay call (800) 750-0750 or 7-1-1, Monday to Friday, 7 a.m. - 7p.m. if:
View a list of pharmacies. View the Preferred Drug List (PDL). View the Molina Prior Authorization (PA) List.
- 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 Ohio. Prescriptions are covered outside of the state of Ohio (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.
View the Preferred Drug List (PDL) Updates.