Pharmacy - Hoosier Healthwise
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Statewide Uniform Preferred Drug List (SUPDL)
All managed care plans are aligned with the fee for service (FFS) program under the Statewide Uniform Preferred Drug List (SUPDL). This means that MDwise covers the same preferred and nonpreferred drugs and maintains the same clinical criteria requirements as other Indiana Medicaid providers.
- The SUPDL may be viewed on the FFS Website. From the homepage, click Preferred Drug List on the right.
- Prior authorization criteria for drugs on the SUPDL may be viewed on the FFS website. From the homepage, click PA Criteria and Administrative Forms on the right. Under the heading Pharmacy Forms, click on Pharmacy Prior Authorization Criteria and Forms.
- The SUPDL may be viewed on the FFS website. From the homepage, click Preferred Drug List on the right.
- Prior authorization criteria for drugs on the SUPDL may be viewed on the FFS website. From the homepage, click PA Criteria and Administrative Forms on the right. Under the heading Pharmacy Forms, click on Pharmacy Prior Authorization Criteria and Forms.
Package A
How the Prescription Benefit Works for Package
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.
Medically needed drugs and some over-the-counter or OTC items are covered for Package A members. The drugs must be approved by the Food and Drug Administration (FDA). A network doctor must prescribe these drugs and OTC items.
You can go to any MDwise network pharmacy. You may search pharmacies and drug prices by selecting the Find a Pharmacy/Drug Price Check link. If languages spoken at participating pharmacies is needed, select MDwise Medicaid Pharmacy Directory (PDF) to view pharmacy location information including languages spoken by pharmacy staff. If you have pharmacy questions or problems, please call 1-800-356-1204.
Copays for Package A
Package A members have no copays for covered drugs when filled at a network pharmacy.
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. For medicines that are not covered, prior authorization (PA) is needed. This means your doctor must send MDwise information. You can request a PA by calling 1-800-356-1204.
Home delivery of your maintenance medicines are also available. Maintenance medicines are taken regularly for chronic or long-term conditions. How to start home delivery or mail order.
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.
Drugs and some over-the-counter (OTC) items are covered for Package C members. The drugs must be approved by the Food and Drug Administration (FDA). A network doctor must prescribe these drugs and OTC items.
You can go to any MDwise network pharmacy. You may search pharmacies and drug prices by selecting the Find a Pharmacy/Drug Price Check link. If languages spoken at participating pharmacies is needed, select MDwise Medicaid Pharmacy Directory (PDF) to view pharmacy location information including languages spoken by pharmacy staff. If you have pharmacy questions or problems, please call 1-800-356-1204.
Copays for Package C
There are copays for Package C member prescription medicines. The copays will be up to $10 when filled at a network pharmacy.
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.
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. For medicines that are not covered, a prior authorization (PA) is needed. This means your child’s doctor must send MDwise information. You can request a PA by calling 1-800-356-1204.
Home delivery of your maintenance medicines are also available. Maintenance medicines are taken regularly for chronic or long-term conditions. How to start home delivery or mail order.
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HHW Package C (CHIP - Children’s Health Insurance Program)
*Members are required to pay applicable copayments at the pharmacy when services are provided.
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Generics
Compounds
Sole Source Drugs
Multisource Brand Preferred Drugs
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$3 copay
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All Other Brand Drugs
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$10 copay
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Preventative Drugs
(Essential Health Benefit)
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$0 copay
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Do you need your prescription refilled?
Below are places we are partnered with where you can get your prescription refilled online.
How Do I Set Up New Prescriptions with Birdi, Inc.?
Option #1: Your Doctor Sends Your Prescription
Your doctor sends your prescription directly to MedImpact's home delivery or mail-order service, Birdi. The prescription is sent electronically or by fax to 1-888-783-1773. Birdi can only accept electronic or faxed prescriptions from your doctor. They will automatically fill and ship most new prescriptions they get from your doctor except for controlled substances.
Option #2: Sign into Website
Sign into their website at www.medimpact.com to request a new prescription or transfer from a retail pharmacy. Choose “Transfer/Request Prescriptions” at the top of “My Prescriptions -> Prescription List”” page and follow instructions.
Option #3: Mail Your Prescription
Fill out the order form or sign in to www.medimpact.com. Visit Documents -> Medication Order Form. Send the form with your prescription(s) to:
Birdi, Inc.
PO Box 51580
Phoenix, AZ 85076-1580
Questions?
If you have questions, please call Birdi toll-free at 1-855-873-8739 (TTY dial 711).
Birdi customer service hours are:
Monday-Friday 8:00 am – 8:00 pm Eastern Time
Saturday 9:00 am – 4:00 pm Eastern Time
Or email them at customerservice@birdirx.com. Email messages are replied to within two
business days. For security and privacy, please do not include personal health information.
Pharmacy Documents and Links
The machine-readable file format is in accordance with CMS regulations and guidance.