Michigan Medicaid Formulary Changes coming Oct. 1

The Michigan Department of Health and Human Services has worked with its health plan partners to create a list of drugs that all Medicaid health plans must cover. This list is called the Michigan Medicaid Managed Care Common Formulary.  Although the final formulary will not be released until Oct. 1, we want to provide advanced notice on two major changes.  Providers with impacted members will be receiving a letter and patient list in the coming weeks.

The following changes are effective 10/1/2018:

Apidra, Humalog and Novolog are moving to non-formulary; Admelog is the formulary alternative.

  • Any patients newly starting Apidra, Humalog or Novolog after 10/1/2018 will not be covered, and instead need to use a formulary alternative, Admelog.
  • Patients currently taking Apidra, Humalog and Novolog can continue to receive these medications until 12/31/2018.  By 01/01/2019, they need to switch to a covered medication.

Symbicort and Dulera are moving to non-formulary; fluticasone-salmeterol is the formulary alternative.

  • Any patients newly starting Symbicort and Dulera after 10/1/2018 will not be covered, and instead need to use a formulary alternative, fluticasone-salmeterol.
  • Patients taking Symbicort and Dulera can continue to receive these medications until 12/31/2018.  By 01/01/2019, they need to switch to a covered medication or contact you to request additional coverage for them.

If you would like to request a coverage determination or a formulary exception, please call toll-free 800.466.6642.  We are open from 8:00 a.m. to 7:00 p.m., Monday through Friday and from 8:30 a.m. to 12:00 p.m. on Saturday.  You may also fax your request to toll-free 877.974.4411.