Preferred Drug List

The Preferred Drug List (PDL) is a list of the drugs that we like our providers to prescribe. We cover all medically necessary Medicaid-covered drugs at many pharmacies. It includes drugs from a pharmacy, not drugs from your doctor’s office or the hospital. The list includes prescription drugs and covered over-the-counter drugs. We also cover all drugs to help you stop smoking like nicotine gum, patches, lozenges and more. You pay $0 for all covered drugs.

The PDL includes drugs on the Michigan Preferred Drug List (PDL)/Single PDL and Common Formulary which is a list of drugs that all Michigan Medicaid health plans must cover.

The PDL may have more than one drug for treating a condition. Some of the drugs are generic. This means that they are not name brand, but they are comparable to the name brand drug and work in the same way.

We also cover medical drugs that are given at your doctor’s office or in a facility. Some medical drugs may need prior authorization. Learn more about these drugs.

We work with the state and other health plans to develop and update the PDL. We update it at least four times a year. We add new drugs and sometimes change the status of some drugs. We will update the website when we make a change. If we make a change to the drug list that affects you, we’ll send a letter to you and your doctor so you have time to talk with them about the change.

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. Please fill out this form to ask for an exception or call Member Services at 1-833-230-2053 (TTY: 711).

Prior Authorization

Some prescriptions may need prior authorization. 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. We work with your doctor for the information we need for prior authorization or exception requests. Your doctor will tell us why the drug is necessary. If we deny a drug request, we’ll send a letter to you and your doctor. The letter will tell you the reason why we denied the request.

Transition of Care

Are you new to Medicaid or HAP CareSource? Are you taking a drug that’s not on the drug list, has restrictions or requires approval? We can cover a temporary supply for drugs that you have been taking. You can get this temporary 30-day supply in the first 90 days when you are new to HAP . Call Member Services to get this temporary supply. Learn more about Transitions of Care in your Member Handbook.

Non-Opioid Directive Form

With the Non-Opioid Directive form (English | Spanish | Arabic), you can tell your providers when you do not want to get opioids. You (or legal guardians) who want to use this directive can download and fill out the form. Give a copy to your providers.

Ask Your HAP CareSource Pharmacist

Do you have questions about your medications? Talk to a pharmacist! You do not need an appointment. Call 1-833-230-2073 (TTY: 711) to speak with a pharmacist today.