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Formulary Tools

Find Out Fast if Your Prescription Drug is Covered!

Do you need to find out if a particular prescription drug is covered by CareSource® MyCare Ohio (Medicare-Medicaid Plan)? You can find out fast by using our online formulary tools.

Formulary Search Tool

The fastest way to find out if your drugs are covered by CareSource MyCare Ohio is to use our Formulary Search Tool. Just click on the link to the Formulary Search Tool. Then follow these steps:

  1. Enter the first few letters of the drug (at least 2 characters). Choose the drug from the drop-down menu. Then click the "Add to List" button.
  2. If the drug you chose is not covered by CareSource MyCare Ohio, you can choose a different strength of the drug. Or, click the "Alternatives Available" link if it is listed.
  3. After you have entered all of your drugs, you can print a list. Click "Print List" in the top right-hand corner of the screen.
  4. If you are finished, click the “X” to close the pop-up box. You will see the "X" at the top right corner of the box.

Special note for members with Medicaid-only coverage through CareSource MyCare Ohio: You can use the Formulary Search Tool to find your covered Medicaid drugs. These drugs are listed in Tiers 3, 4 and 5 in the search tool. To find out about your covered Medicare Part D drugs, please contact your Medicare health plan.

Online Comprehensive Formulary

You can also click the link below to see a complete list of all of the drugs covered by CareSource MyCare Ohio. This list is called the Comprehensive Formulary. Sometimes it is also called the Preferred Drug List.

Comprehensive Formulary (Preferred Drug List)
 

Special note for members with Medicaid-only coverage through CareSource MyCare Ohio: You can use the online Comprehensive Formulary to find your covered Medicaid drugs. In the online Comprehensive Formulary, these drugs are marked with an asterisk (*). To find out about your covered Medicare Part D drugs, please contact your Medicare health plan.

Enjoy the benefits of a single plan for both your Medicare and Medicaid. Call 1-800-324-8680 and ask Ohio Medicaid to enroll you with CareSource MyCare Ohio for both Medicare and Medicaid.

Other Online Formulary Tools

From time to time our Preferred Drug List may change. Also, some drugs may require you to get a prior authorization. You can find out about these and other drug-related topics by clicking the links below:

Formulary Facts for You

A formulary is a list of drugs covered by CareSource MyCare Ohio to meet the needs of our members. Doctors and pharmacists check the list and update it to make sure you get the drugs you need.

CareSource MyCare Ohio covers both generic drugs and brand-name drugs. Generic drugs have the same formula as a brand-name drug. Generic drugs often cost less than brand-name drugs. Generic drugs are rated by the Food and Drug Administration (FDA) to be as safe and to work as well as brand-name drugs.

Our drug list may change during a calendar year, if we:

  • Remove drugs from the list
  • Add prior authorization on a drug
  • Add quantity limits or step therapy restrictions on a drug
  • Move a drug to a higher cost-sharing tier

We must let you know if a drug you are taking is changing at least 60 days before the change happens. However, if the FDA decides a drug is not safe or if the drug is no longer sold, we will remove the drug from our formulary right away. We must also give notice to you if you are taking the drug.

Still Have Questions About Your Prescription Drug Coverage?

Please call our Member Services Department at 1-855-475-3163 (TTY: 1-800-750-0750 or 711) for more information. Member Services hours are Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern Standard Time (EST).




Updated August 26, 2014

H8452_OHMMC197
 CMS Approved 10-8-2014