What is a formulary in a health insurance plan?

A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.

Does Michigan Medicaid cover insulin?

The Health Plans may be “less restrictive” than the Common Formulary. For example, some health plans may cover insulin pens without prior authorization for beneficiaries over the age of 21. MHPs must at a minimum cover insulin pens for beneficiaries (members) under the age of 21.

Does Michigan Medicaid cover diabetic supplies?

UnitedHealthcare Community Plan of Michigan uses the Michigan Medicaid Single Preferred Drug List (PDL) for Fee for Service and Managed Care Organizations (MCOs). Diabetic supplies are not included on the single PDL.

Does Meridian cover insulin pumps?

Implantable insulin pumps (IIP) for the treatment of diabetes are considered experimental and investigational and currently are not a covered health service due to lack of clinical evidence of safety and or efficacy in published peer reviewed medical literature.

What is Meridian prescription drug plan coverage?

Prescription Drug Plan Coverage. MeridianRx is our full-service Pharmacy Benefit Manager that provides MeridianHealth members and providers with a pharmacy network, pharmacy claims management services, a drug formulary, and pharmacy claims adjudication. Member eligibility is determined prior to authorizing any drug benefit.

When will meridianhealth be transitioning to Michigan’s common drug formulary?

Note: Effective 9/30/2016, MeridianHealth will be transitioning to Michigan’s Common Drug Formulary. For more information, visit the Michigan Department of Health and Human Services page.

How does meridianrx work with meridianhealth?

Prescription Drug Plan Coverage MeridianRx is our full-service Pharmacy Benefit Manager that provides MeridianHealth members and providers with a pharmacy network, pharmacy claims management services, a drug formulary, and pharmacy claims adjudication. Member eligibility is determined prior to authorizing any drug benefit.

How do I get prior authorization for meridianrx?

Obtaining Prior Authorization. To prescribe a drug that requires prior authorization and/or a drug is not in the drug formulary, providers must complete a Medication Prior Authorization Request Form or a Formulary Exception Form. These forms must be faxed to MeridianRx at 855-580-1695.