Pharmacy Information And Tools

Healthy Blue will administer pharmacy benefits for enrolled members. IngenioRx* is the pharmacy benefits manager.

Medicaid

Please refer to the preferred drug list (PDL) when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.

Though most medications on the PDL are covered without prior authorization, a few agents will require you to contact our Pharmacy Department for authorization.

Prior Authorizations By Phone:

You can reach our Pharmacy department at 1-833-388-1406 between 8:00 a.m. and 9:00 p.m. CST Monday to Friday.

Phone:

1-833-388-1406

Prior Authorizations By Fax:

You can also fax your request to our Pharmacy Department:

Retail prior authorization:

1-833-370-0702

Medical injectables:

1-833-370-0678

Documents

• Respiratory Syncytial Virus Enrollment Form
• Prior Authorization Form For Medical Injectables
• Pharmacy Prior Authorization Form
• Recipient Choice Of Restricted Services (Lock-In) Provider Agreement
• CVS Pharmacy Update -New Implementation January 2021

Related Information

Pharmacists and Medical Professionals’ Resources

Formulary Searchable Tool (Pharmacy Benefit)

Preferred Drug List

Common Over-The-Counter (OTC) Medicines

Medicaid Summary Of Drug Limitations

Prior Authorization Forms 

Referrals 

• Specialty Drug List

* IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Healthy Blue.