Preferred Drug List

Our drug list has more than one drug for treating a health issue. These are called alternative drugs. Alternative drugs are just as good as other drugs with similar side effects.

CareSource also covers many commonly used over the counter (OTC) medications with a written prescription from your provider. If there are any changes to the PDL, they are posted below each quarter.

Preferred Drug Lists

Find My Prescriptions

Do you want to look up your medicine and find out if it is covered by CareSource? It’s easy when you use our Find My Prescriptions tool. This tool will help you learn how to find your medicine.

Prior Authorization

Some prescriptions may need a prior authorization (PA). This means that a drug will need to be reviewed and approved before you can fill it. Your provider will make this request for you. Learn more about Navigate PA requirements for medications.

How to Request a Medicine Not on the PDL

You can ask us to cover a medicine that is not on our preferred drug list. This is called asking for an exception. To ask for an exception, please fill out this form.

Generic Substitution

A drugstore will give you a generic drug in place of a brand name drug. Generic drugs have the same effect and safety as brand name drugs. Your provider will need our approval if they ask for a brand name drug when a generic drug is available.

Therapeutic Interchange

Sometimes you can’t take a certain drug, like if you have an allergy. Other times, a drug might not work for you. In these cases, your provider can ask us to cover a drug that is not on the approved drug list.

Step Therapy

Sometimes, CareSource requires that you try a less expensive drug used for the same condition before “stepping up” to a medication that costs more. This is called step therapy. Certain drugs may only be covered if step therapy is used.

Quantity Limits

Some drugs have limits on how much can be given to you at one time. Quantity limits may be based on factors such as the drug makers’ recommended dosing, patient safety, or the Food & Drug Administration (FDA) recommendations.

Drug Safety Recalls

Sometimes, a drug manufacturer or the federal government issues drug recalls. To find out if a drug you take is being recalled, please check the listings on the U.S. Food & Drug Administration website.

Member Services: 1-855-202-0729 (TTY: 711), open Monday through Friday 7 a.m. to 7 p.m.