Pharmacy
Extra Care To Manage Your Condition
Your pharmacy benefits are covered under the state Medicaid program and managed by Gainwell Technologies. If you have questions about your pharmacy benefits, call 833-491-0344 or visit the Gainwell website. You may us this link to log in to the member secure portal to view your:
Medicaid claims and notifications
Medicaid programs and benefits
Directory of providers
Members will use Gainwell to process prescription claims and will need to refer to the Gainwell member handbook for assistance.
Gainwell has a list of prescription medicines included on the Preferred Drug List, or PDL. The PDL is a list of medicines that Gainwell covers.
There are brand name medicines and generic medicines on the Preferred Drug List. You can get many of these medicines at your pharmacy with a prescription from your doctor. but, some of these medicines must have an approval from the Gainwell pharmacy program before you can get them.
This approval is called a prior authorization, or PA. Your doctor must ask for a PA for some of the medicines on the list. Sometimes your doctor can change your prescription to a medicine that doesn’t need a PA. But if your doctor says you must have medicine that needs an approval, they must ask for a PA.
You can also visit the Gainwell website to view the pharmacy handbook, the list of drugs covered under your pharmacy benefit (Preferred Drug List), and the provider directory.
Physician Administered Medical Injectable
Some injectable medications may be given in your doctor’s office. These are not injections that you can give to yourself. For this type of medication, your doctor can call us for help with which medications are covered under your medical benefit. Some of these medications may also need an approval from us before you get them.