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 #147 (updated May 2020)
- Medicaid Formulary Changes #148 (updated July 2020)
- Medicaid Formulary Changes #149 (updated September 2020)
- Medicaid Formulary Changes #150 (updated December 2020)
- Medicaid Formulary Changes #151 (updated February 2021)
- Medicaid Formulary Changes #152 (updated April 2021)
- Medicaid Formulary Changes #153 (updated May 2021)
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 Plans 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
Health Partners Medicaid 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.
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.
Medication Therapy Management (MTM)
Medication Therapy Management (MTM) is a program designed to help our members with specific medical needs take their medications safely and effectively. MTM is not a benefit and is only available to members who fulfill the criteria outlined below.
For more information
- Call our 24-hour Member Relations line at 215-849-9600 or 1-800-553-0784.
- TTY line for the deaf or hearing/speech-impaired is available at 1-877-454-8477.
- Health Partners members can also view pharmacy claims, determine financial responsibility for a drug and get other prescription benefit information 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