The Medicaid Preferred Drug Program (PDP) promotes the use of less expensive, equally effective prescription drugs when medically appropriate. Learn more about the Preferred Drug Program.
Most preferred drugs are available without prior authorization.
Prescribers must obtain prior authorization before prescribing non-preferred drugs.
For questions and comments:
For consumers beginning new therapy, providers can choose a preferred medication or request a prior approval before the consumer fills their prescription.
Medicaid Pharmacy Program
Information regarding the Medicaid Pharmacy Program is available through the Department of Health.
Medicaid works with consumers to enroll them in an available plan depending on their county of residence. There is a choice of managed care plans in most counties; however, a few counties only have one plan.
Enrollment in Medicaid Managed Care is available at any local Department of Social Services.
Consumers have only 90 days from date of enrollment to choose another plan in each enrollment year. Plans must provide a one-time, temporary fill for non-formulary drugs for up to a 30-day supply of medication.
When a consumer enrolls in a Managed Care plan, all pharmacy benefits are provided by that plan. Prior approval rules will apply. Exceptions apply to consumers who have Supplemental Security Income (SSI) or SSI-related enrollees and the coverage of long-acting injectable antipsychotics.
What if the consumer has a Medicaid Identification card, but does not have a plan identification card and does not know the name of his/her plan? Prescribers can confirm a member's enrollment information by calling the New York Medicaid Management Information system: 1-800-997-1111.