Health Partners Formulary Search

Welcome

As of January 1, 2020, all managed care organizations (MCOs) that provide outpatient drug services to Medicaid beneficiaries in Pennsylvania and the State Fee-for-Service (FFS) program will use the same Preferred Drug List (PDL). Any drugs designated as non-preferred will require prior authorization. The Statewide PDL can be accessed at papadl.com.

In addition, Health Partners Plans will also have a Supplemental Formulary which will cover medications that are not included in the Statewide PDL.

Additional Legend Information

PRD = Statewide PDL Preferred

NP = Statewide PDL Non-Preferred

SC = Covered on Health Partners Plans Supplemental Formulary

NF = Non-Formulary, drug is not covered on Statewide PDL or Health Partners Plans Supplemental Formulary

How to Search For Drugs

Use the alphabetical list to search by the first letter of your medication.

Search by typing part of the generic (chemical) and brand (trade) names.

Search by selecting the therapeutic class of the medication you are looking for.

How to Request an Exception

You can ask us to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make:

You can ask us to cover your drug even if it is not on our formulary.

You can ask us to waive coverage restrictions or limits on your drug.

You can ask us to provide a higher level of coverage for your drug.