Medicaid Drug Search


You can search the formulary alphabetically by selecting the first letter of the drug you are looking for, or by either the Brand or Generic name of a drug by entering the name of the drug if the first few letters or the full name or correct spelling is not known. 

You can also search the formulary by Therapeutic Class of the drug if the exact drug name is not known. 

Some of the medications on the formulary require prior authorization, have a quantity limit, must be dispensed by a specialty pharmacy or require step therapy. These medications are marked with a symbol under the Notes & Restrictions column. If the drug you need requires prior authorization, your physician can submit a Drug Specific Prior Authorization Form.

If your drug is not included in this formulary, you should first contact Member Services and ask if your drug is covered.

A physician may request a non-formulary medication only if medical necessity or failure of formulary alternatives are documented by the physician on the Medicaid Drug Exception Form

Direct Member Reimbursement Claim Request (DMR)
Specialty Drug List
Specialty Pharmacy Provider List
Statewide Preferred Drug List (PDL) Drug Products (PDF)
Highmark Wholecare-Specific Supplemental Formulary Drug Products (PDF)



This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 27 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

Questions?

One of our friendly Highmark Wholecare representatives is available to take your call.

Medicaid: 1-800-392-1147
8am to 8pm, Monday through Friday

(TTY# 711 for hearing impaired)

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