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Medicaid Plan
Find a Covered Drug

The Health Partners Plans Medicaid formulary is a list of the preferred drugs that are covered by your health plan. You can also use the formulary to find out about medication side effects, interactions and proper usage.

Search the Formulary
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Statewide Preferred Drug List

The Department of Human Services (DHS) has implemented a Preferred Drug List (PDL) for all Pennsylvania Medicaid members. Click the link below to access the statewide PDL.

Preferred Drug List
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Specialty Medications and Pharmacies

Specialty medications are prescription drugs that require special handling, administration or monitoring. These medications treat complex chronic conditions and are only available from a specialty pharmacy. See the Specialty Medication List for a list of these drugs.

Health Partners Plans works with a network of specialty pharmacies to coordinate the delivery of specialty medications for our members. See below for a list of these pharmacies.

For more information about specialty medications and pharmacies, please call Member Relations at 1-800-553-0784 (TTY 1-877-454-8477).

Accredo Health Group

3000 Ericsson Drive 
Suite 100
Warrendale, PA 15086
Phone: 877-720-7445
Fax: 866-768-2998

 

Apovia Pharmacy Services

313 Henderson Drive
Sharon Hill, PA 19079
Phone: 267-901-0000
Fax: 267-546-4324

 

Bank's Apothecary Specialty Pharmacy

3800 Horizon Blvd. 
Suite 103
Trevose, PA 19053
Phone: 215-494-9403
Fax: 215-357-2129

 

Coordinated Care Network Pharmacy

300 Penn Center Blvd.  
Suite 405  
 PA 15235
Phone: 412-349-6300
Fax: 412-349-6724 

CVS Specialty Pharmacy

1117 Walnut Street  
Philadelphia, PA 19107
Phone: 866-813-3899
Fax: 215-627-8943

 

Elwyn Specialty Care

3070 McCann Farm Drive  
Garnet Valley, PA 19060
Phone: 610-545-6040
Fax: 610-545-6030

 

Ganse Apothecary

355 W King Street
Lancaster, PA 17603
Phone: 717-394-5671 
Fax: 717-427-1632

 

Genoa Healthcare, LLC

807 Lawn Ave, Suite 104
Sellersville, PA 18960
Phone: 267-354-8166
Fax: 267-443-1334

LifeTree Pharmacy

5 Blue Heron Drive  
Collegeville, PA 19426
Phone: 610-489-6640
Fax: 610-489-6645

 

Premier Pharmacy Services

1049-51 Broadway #2  
Bethlehem, PA 18015
Phone: 800-540-4700
Fax: 800-540-3400

 

Soleo Health, Inc.

950 Calcon Hook Road
Suite 19 
Sharon Hill, PA 19079
Phone: 610-200-6502 | 866-737-1919
Fax: 610-726-1882

 

SunRay Drugs Specialty

142 S. 52nd Street  
Suite 201  
Philadelphia, PA 19139
Phone: 888-260-9555
Fax: 215-471-4001

Valeda Rx, LLC

250 Mt. Lebanon Blvd  
Suite 208  
Pittsburgh, PA 15234
Phone: 844-698-2533
Fax: 844-733-3779

 

Value Specialty Pharmacy

1333 Plank Road  
Suite 200  
Duncansville, PA 16635
Phone: 855-265-8008
Fax: 844-812-6227

 

Walnut Home Therapeutics, Inc.

3500 Horizon Drive
King of Prussia, PA 19406
215-955-8154
215-955-8182

Formulary Changes
Prior Authorizations

Some services, medicines, or items need approval from Health Partners before you can get the service. This approval process is called prior authorization. “Prior authorizations” are sometimes referred to as “preauthorizations” or “precertifications” or “preapprovals” – they mean the same thing.

Learn More
Over-the-Counter Medicines

Health Partners Plans’ Medicaid covers over-the-counter medicines when you have a prescription from your provider. You will need to have your Health Partners Plans ID card with you. The following are some examples of over-the-counter medicines that may be covered:

  • Sinus and allergy medicine
  • Tylenol or aspirin
  • Vitamins
  • Cough medicine
  • Heartburn medicine such as antacids and famotidine
  • Vaporizers
For More Information
  • Call Member Relations at 1-800-553-0784 (TTY 1-877-454-8477).
  • Health Partners members can also view pharmacy claims and other prescription benefit information including financial responsibility for a drug and initiate a prior authorization (formulary exception) request on our pharmacy portal.
Frequently Asked Questions

The Health Partners Plans Medicaid formulary contains two kinds of drugs: brand name and generic. This could affect which medications you get when using your benefit. When you search for a brand name drug on the formulary, you will see a generic equivalent (if available). View our formulary for more information.

Health Partners Plans Medicaid works with local doctors and pharmacists to select the drugs in the formulary. We choose drugs that are safe, effective and high quality. New drugs and treatments are reviewed regularly. We make changes to the formulary as needed.

Your PCP must ask us to approve for you. This is known as prior authorization. When we receive a complete request for prior authorization, we will contact you by phone within two business days from the date we received the request to tell you if we approved the service or item requested. Learn more.

Health Partners Plans Medicaid typically limits medications to a 30-day supply. However, we offer an option for inexpensive chronic medications to be dispensed for a 90-day supply. This list is subject to change without notice.

A 90-day supply is also available through our mail order pharmacy, Caremark. Getting your prescriptions by mail is convenient. You will never miss a refill. You must have a valid prescription to use this service. Please note, not all covered drugs are available for mail order. View the complete list of 90 days’ supply medications. To learn more, call 1-800-756-7186 or visit Caremark.com/mailservice.

To view a drug recall list, click here. If you are impacted by a drug recall, you will receive a drug recall notice from Health Partners Plans Medicaid.

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