Prescription Drug Information
Health Partners (Medicaid) formulary is a list of the preferred drugs that are covered by your health plan.
Health Partners (Medicaid): Effective January 1, 2020, the Department of Human Services (DHS) is implementing a Preferred Drug List (PDL) for all Pennsylvania Medical Assistance members. Click here to access the statewide PDL.
- Health Partners Medicaid PDL and Supplemental Formulary. Click here to access the Health Partners Medicaid PDL and Supplemental Formulary
You can also use the formulary to find out about drug side effects, interactions, risks and proper usage. To view this information, click on the icon for “Details” in your search results.
Recent updates to our formularies (by plan)
Throughout the year, HPP may elect to make changes to our formularies. Use these links to see the most recent updates to formularies, prior authorization requirements, quantity limits, age edits, and more.
Health Partners (Medicaid):
- Medicaid Formulary Changes #162 (updated October 2022)
- Medicaid Formulary Changes #163 (updated January 2023)
- Medicaid Formulary Changes #164 (updated February 2023)
- Medicaid Formulary Changes #165 (updated February 2023)
- Medicaid Formulary Changes #166 (updated February 2023)
- Medicaid Formulary Changes #167 (updated February 2023)
Brand name and generic drugs
The Health Partners (Medicaid) formulary contains two kinds of drugs: brand name drugs and generic drugs. Health Partners usually does not include a brand name when the same medicine comes as a generic. This may affect which medications you get when using your Health Partners prescription benefit. When you search for a brand name drug, the formulary will show you the generic equivalent, if available.
Health Partners worked with participating local doctors and pharmacists to select the drugs in this formulary. The drugs were chosen because they are safe, effective and high quality. New drugs and treatments are reviewed regularly. Health Partners will make changes to the formulary as needed.
90 Days’ Supply (At Pharmacy Locations or by Mail)
Health Partners typically limits medications to a 30 days’ supply. However, we do offer the option for inexpensive, chronic medications to be dispensed for a 90 days’ supply for all pharmacies in our network. Please note this list is subject to change without notice.
In addition, 90 days’ supply is available through our mail order pharmacy, Caremark. Getting your prescriptions by mail is a convenient way to never miss a refill. You must have a valid prescription to use this service. Not all covered drugs are available through mail order.
Health Partners relies on a single mail order pharmacy to better serve our members. To learn more, call 1-800-552-8159 or visit Caremark.com/mailservice (You will leave the Health Partners website).
Find a Pharmacy
Use our online lookup tool to locate an in-network pharmacy near you.
You can search for a pharmacy using these simple steps:
- Enter a word “pharmacy” or the name of a specific pharmacy, into the search box and press the “Go” button.
- You can narrow your search by entering a zip code into the zip code box at the top of the page, but you must still use the “Go” button next to the search box to receive the appropriate results.
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.
Health Partners (Medicaid) works with a network of specialty pharmacies to coordinate the delivery of specialty medications for our members.
A drug recall list can be found here. Any members affected will receive a drug recall from HPP.
For more information
- Call our 24-hour Member Relations line 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.
Member Relations can also help you:
- Check if you are eligible to get prescriptions
- Find a pharmacy
- Get a listing of participating pharmacies
- Get a printed copy of the formulary
- Initiate a Formulary Exception Request