Filling prescriptions: HMO plans
- Check the Medicaid Approved Drug List (ADL) to see what drugs are covered and how.
- You must get your prescriptions from a network pharmacy. Check the list of participating pharmacy chains, or search for pharmacies in our online Find a Doctor tool to find a pharmacy near you.
- You must bring your Priority Health ID card with you to the pharmacy. Your ID card has important billing information the pharmacy will need to bill your prescription. A digital copy of your ID card is available in your member account.
"Tiers" are simply a way of grouping prescription drugs by cost and purpose. Generic drugs are the least expensive because they are not brand names. It's the difference between buying Kleenex® Tissue and other tissues; some are equivalent to brand-name products in the way they're made, and some just treat the same conditions, but they cost less, so your copay may be lower.
- "Preferred brand" drugs may cost more than a generic, but you'll often pay a lower copayment than for non-preferred brand drugs.
- "Non-preferred brand" drugs are the most costly drugs, so your copayment may be higher with these prescriptions. Ask your provider to prescribe a generic or preferred drug whenever possible.
- "Preferred specialty" drugs are generally self-administered medicines used for a chronic illness. They have special handling requirements or require special training before use.
- "Non-preferred specialty" drugs are more costly than the preferred specialty drugs. Ask your provider to prescribe a preferred specialty drug whenever possible.