Drug Formulary

Beginning January 1, 2020, CareSource adopted Ohio Medicaid’s Unified Preferred Drug List (UPDL). For drugs outlined by the UPDL, the Ohio Department of Medicaid (ODM) and the managed care plans (MCPs) have the same preferred and non-preferred medications and utilize the same UPDL criteria for pharmacy benefit products. Prescribers can access the UPDL documents online through ODM’s website by viewing the UPDL and UPDL criteria.

Please see www.caresource.com references for additional prior authorization requirements, quantity limits, and compound coverage.

CareSource also maintains a NavigatePreferred Drug List (PDL), or formulary, that is updated quarterly and includes products both on and off of Ohio’s UPDL. You can view an abbreviated version of the PDL on our NavigateFormulary Quick Reference Guide. You can also view the list of NavigateCovered OTC Products here or using the Formulary Search Tool.

We also have a NavigateList of Covered Vaccines to help you determine if a vaccine is covered at your office or at a local participating pharmacy and if there are any requirements for coverage. Preventive vaccines for children (ages 0 to 18) are covered as part of the federally funded Vaccines for Children program and generally are not covered at local pharmacies.

Online Drug Formulary

We offer an online Formulary Search Tool that can help you quickly look up medications for CareSource members. It’s easy! You can find out if a medication is covered by searching alphabetically, by brand and generic name, or by therapeutic class.

Additional information is available on the Pharmacy page.

Drug coverage information for our formulary is also available on Fingertip Formulary, a medical application you can download to your mobile device. You can also determine drug coverage status on the MMIT Formulary, another application that can be downloaded onto your mobile device.

Drug Formulary Changes

Each quarter, there may be changes to our PDL. You can check the list of drug formulary changes to see if any of these changes affect the medications you prescribe.