Pharmacy
Prescription drugs
You will have access to all of the covered prescription drugs that are part of the Montgomery County Care drug formulary. Prescriptions can only be filled at pharmacies located in Montgomery County.
We use a Preferred Drug List (PDL) to show the drugs we prefer that your provider prescribes. Prescriptions for Montgomery County Care members are filled with generic drugs and require that you pay a $5 co-pay. Montgomery County Care members may obtain certain insulin, diabetic supplies and asthma medications through the program when prescribed by primary care providers of the Community Health Centers of Greater Dayton.
Montgomery County Care has an individual pharmacy benefit limit of $2,000 per calendar year.
You can call Member Services at 1-877- 892-7482 (1-800-750-0750 or 711) if you have questions about your pharmacy benefit.
We know you may have questions about Montgomery County Care prescription drug benefits. Here are some questions we are often asked:
What pharmacies can I use?
You can fill your prescriptions at any pharmacy that participates in Montgomery County Care and is located in Montgomery County. Exception: Prescriptions for insulin, diabetic supplies and asthma medications must be filled at Ridgway or St. Elizabeth (North Main St. location) pharmacies.
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How do I find out if my drug is covered?
You can look at the Preferred Drug List (PDL) or you can call Member Services at 1-877-892-7482 (1-800-750-0750 or 711), Monday through Friday, 7 a.m. to 7 p.m.
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Are the doctors in the network aware of your prescription drug benefits?
Yes. Your PCP has been notified in writing of the drugs included in our formulary.
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Does CareSource require Prior Authorization?
No, because CareSource only covers the cost of drugs that are on the Preferred Drug List (PDL).
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If my drug is not part of the pharmacy benefit, how can I get it?
You can pay the full price of the drug if it is not part of the Preferred Drug List (PDL). There are also other community resources that might be able to help you:
Many chain pharmacies offer store discount cards for items bought in their store. Each store application process is different. Ask at the front counter if they offer discount cards.
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Will the Preferred Drug List change?
The Preferred Drug List can change. Please check the website regularly for updates.
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Will I have a co-pay for my prescription drugs?
Yes. Prescriptions for Montgomery County Care members require a $5 co-pay.
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What happens if I lose my medicine or it is stolen?
Montgomery County Care will cover lost or stolen medications one time per year. You will have to pay the co-pay to refill the prescription. We may require approval from your doctor or a police report for certain lost or stolen drugs.
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