Medicaid preferred drug list (formulary)
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. We also cover some commonly prescribed over-the-counter (OTC) medications. Please refer to our
when prescribing these medications for our members.
Electronic prior authorizations (ePA)
Electronic prior authorization requests can be submitted through CoverMyMeds, an independent company providing medication prior authorization services on behalf of Highmark Blue Cross Blue Shield of Western New York.
CoverMyMeds streamlines the medication prior authorization process, electronically connecting providers, pharmacists and plan/PBMs to improve time to therapy and decrease prescription abandonment with electronic prior authorization.
Using CoverMyMeds for prior authorization (PA) requests
Prescribers can view real-time status of any medication PA request submitted via ePA, phone, or fax by logging into the CoverMyMeds website and entering the member’s information. Prescribers also have the option to contact CoverMyMeds directly by calling 866-452-5017 for questions, information, or website concerns, or via live chat on the CoverMyMeds website.
Prior authorizations by phone:
You can reach our Pharmacy department at 1-866-231-0847 between 8 a.m. and 7 p.m. Eastern time Monday through Friday and 10 a.m. to 2 p.m. Eastern time on Saturday.