Louisiana Department of Health & Hospitals | Bruce Greenstein, Secretary

Pharmacy Services

HOW TO ACCESS:

Pharmacies

ELIGIBILITY:

All Medicaid recipients except some who are Medicare/Medicaid eligible.  Recipients who are full benefit dual eligible (Medicare/Medicaid) received their pharmacy benefits through Medicare Part D.

COVERED SERVICES:

• Covers prescription drugs except:
• Cosmetic drugs (Except Accutane);
• Cough & cold preparations;
• Anorexics (Except for Xenical);       
• Fertility drugs when used for fertility treatment;
• Experimental drugs;
• Compounded prescriptions;
• Vaccines covered in other programs;
• Drug Efficacy Study Implementation
• (DESI) drugs;
• Over the counter (OTC) drugs, with some exceptions;
• Narcotics prescribed only for narcotic addiction.

COMMENTS:

Co-payments ($0.50-$3.00) are required except for some recipient categories.

NO co-payments for recipients under age 21, pregnant women, or those in Long Term Care.

Prescription limits: 4 per month (The physician can override this limit when medically necessary.)  Limits do not apply to recipients under age 21, pregnant women, or those in Long Term Care.

Prior Authorization is required for some drug categories if the medication is not on the Preferred Drug List (PDL).  Children are not exempt from this process. The PDL can be accessed at www.lamedicaid.com  


For general pharmacy questions: 1-800-437-9101