NYS Medicaid Managed Care Pharmacy Benefit Information Center
MMC News  

Effective April 1, 2023 the pharmacy benefit for New York State Medicaid Managed Care members will be transitioned to NYRX, the Medicaid Pharmacy Program formerly known as Medicaid Fee-for-Service. For detailed information about this transition please visit the NYRx pharmacy benefit transition website. Helpful Links

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This website is designed to provide easy access for members and providers looking for information on the drugs and supplies covered by different Medicaid health care plans. While pharmacy benefits and participating pharmacies vary among health plans, all plans maintain their own web sites and customer service call centers.

To use this website, you should first check your health plan identification card and match it to the one presented on this website. By clicking on the appropriate identification card/logo you will be provided with contact numbers and links to your health plan's website including links to prior authorization (PA) forms and drug look-up options. If you do not have your health plan identification card or do not know what health plan you are enrolled in, call the Medicaid Helpline at 1-800-541-2831 from 8am through 8pm, Monday through Friday and from 9am to 1pm on Saturday.

Each managed care plan has its own list of covered drugs (called a formulary). If you would like to find out if a drug is covered, please perform a drug look-up search.

Managed Care Plans

Affinity Health Plan Amida Care Health Now Capital District Physicians Health Plan Emblem Health Excellus BCBS Health Plan Fidelis Care HealthFirst Empire Blue Cross Blue Shield Health Plus Independent Health MetroPlus Health Plan MVP Molina Healthcare UnitedHealthcare UniveraHealthcare Visiting Nurse Service of NY Choice Health Plans

Contact Information

For questions regarding your eligibility or to find out which managed care plan you are enrolled in, you may call the Medicaid Helpline at 1-800-541-2831. It is available from 8:00 a.m. through 8:00 p.m., Monday through Friday and from 9:00 a.m. to 1:00 p.m., on Saturday.

Please let us know if you’re having difficulty with this website, if any of the links are broken, or if you have a suggestion for additional content by clicking here: contact us.

Disclaimer

The New York State Department of Health (NYSDOH) obtains drug formulary information from Medicaid participating managed care plans on a quarterly basis. Please note NYSDOH publishes the drug formulary information as it is received. This information was last updated on 2023-01-20. As a best practice, always contact or visit your managed care plan's website to obtain the most current information regarding drug coverage.