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
If you have questions or need a definition, please check our frequently asked questions (FAQs) page.
To find out if a drug is covered, please type in the drug name and then select from the drop down menu. Then choose whether you are looking for the brand or generic formulation of the drug, or both. Lastly, select the health plan(s) you would like to compare. See the Drug Quicklist tab to view drugs listed by selected therapeutic classes.
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Please note, the drug look-up reflects drug coverage under the pharmacy benefit of each plan (which may include specialty pharmacy drugs). It is not inclusive of all covered practitioner administered or certain over-the-counter drugs and or supplies. Additional drugs may be covered under the medical benefit of each plan. Please refer to the plans website for more detailed information on physician administered drugs available under the medical benefit.
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.