MDwise

Package A & B

Medicines for MDwise Hoosier Healthwise members are covered. You can go to any pharmacy that accepts Indiana Medicaid. If you have pharmacy questions or problems, please call 1-800-356-1204. You can find a list of all available pharmacies and drug prices on our Find a Pharmacy/Drug Price Check page.
 

How the Prescription Benefit Works for Package A & B

When you need medicine or over-the-counter items, your doctor will write a prescription. You can take that prescription to any MDwise participating pharmacy.

Copays for Package A & B

You will need to pay a $0.00 for a generic prescription, or $0.00 for a brand prescription when filled at and participating MDwise pharmacy.
 

You do NOT have to pay pharmacy copay if:

1. It is family planning supplies (birth control).
2. It is medicine dispensed in an emergency room.
3. You are younger than 18 years of age.
4. You are pregnant.
5. You are inpatient in a hospital, nursing facility, intermediate care facility, or other medical institution.
    

Prescription Medicine for Package A & B

Hoosier Healthwise covers necessary medicines. Your doctor must prescribe these medicines. It must be a medicine approved by the Food and Drug Administration (FDA).

Hoosier Healthwise gives your health care provider a tool called a formulary.

This helps him or her prescribe drugs for you. A formulary is a list of some of the brand and generic medicines covered by MDwise Hoosier Healthwise. MDwise Hoosier Healthwise members can call 1-844-336-2677 to ask about medicines that are covered.

If you have Internet access, you can go to the Find a Drug page. This drug list also tells you some of the over-the-counter medicine and vitamins that are covered.

Home delivery of your maintenance medicines are also available. Maintenance medicines are taken regularly for chronic or long-term conditions. Click HERE for more information on how to start home delivery or mail order.

Package C

Medicines for MDwise Hoosier Healthwise members are covered. You can go to any MDwise participating pharmacy. If you have pharmacy questions or problems, please call 1-800-356-1204. You can find a list of all available pharmacies and drug prices on our Find a Pharmacy/Drug Price Check page.

How the Prescription Benefit Works for Package C

When you need medicine or over-the-counter items, your doctor will write a prescription. You can take that prescription to the pharmacy.

Copays for Package C

There are copays for your child’s prescription medicine. The copays will be $3.00 for each generic medication and $10.00 for each brand medication.

Prescription Medicine for Package C

Hoosier Healthwise covers necessary medicines. Your child’s doctor must prescribe these medicines. It must be a medicine approved by the Food and Drug Administration (FDA).

Hoosier Healthwise gives your child’s health care provider a tool called a formulary.

This helps him or her prescribe drugs for you. A formulary is a list of some of the brand and generic medicines covered by Hoosier Healthwise. MDwise Hoosier Healthwise members can call 1-844-336-2677 to ask about medicines that are covered.
 
If you have Internet access, you can go to the Find a Drug page. This drug list also tells you some of the over-the-counter medicine and vitamins that are covered. 

Home delivery of your maintenance medicines are also available. Maintenance medicines are taken regularly for chronic or long-term conditions. Click HERE for more information on how to start home delivery or mail order.

*HHW Package C pharmacy copays may be lower for some T2 single source brand medications.

Icon	Status	Definition	HHW Plan A&B Copay	HHW Plan C Copay
	Tier 1	Generic Drugs	$0	$4
	Tier 2	Brand Drugs	$0	$8
	Tier 3	Essential Health Benefit Drugs	$0	$0
	Non-Formulary	Non-Formulary	Not covered under pharmacy benefit (coverage MAY be available under the medical benefit).	Not covered under pharmacy benefit (coverage MAY be available under the medical benefit).

 

Pharmacy Documents and Links

Look Up Drug-Drug Interactions     |     Drug Side Effects
Best Practices Generic Dispensing Rates
E-Prescribing and Formulary Searching
MDwise Hoosier Healthwise Printable Formulary
Medicaid Pharmacy Prior Authorization Guidelines for Hoosier Healthwise and HIP
Medical Prior Authorization and Exclusions Lists