Pharmacy
It’s important to Louisiana Healthcare Connections that our members receive drug therapy that is appropriate, high quality and cost effective. We work hard to ensure you have access to safe and effective medications that are medically proven to help you get healthy and stay healthy.
Prescription Drugs and Over-the-Counter Drugs
Louisiana Healthcare Connections covers certain prescription drugs and over-the-counter drugs when prescribed by a Louisiana Healthcare Connections provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage or maximum quantities. These limits make sure your medicines are safe and effective.
Diabetic Supplies
Louisiana Healthcare Connections covers some diabetic supplies with a prescription. These include certain meters, pen needles, syringes, and test strips. Your doctor can find a list of covered diabetic supplies on our website.
A Preferred Drug List (PDL) is a list of drugs covered by your health plan. The Louisiana Medicaid Single PDL (Fee For Service and Managed Care Organizations) is the list of drugs covered by Medicaid in Louisiana. All Healthy Louisiana Medicaid health plans, including Louisiana Healthcare Connections, follow this PDL.
The PDL applies to drugs you receive at retail pharmacies. The Louisiana Medicaid Single PDL (Fee For Service and Managed Care Organizations) is reviewed on a regular basis by the Louisiana Department of Health’s Pharmaceutical and Therapeutics Committee. The committee’s goal is to promote the appropriate and cost-effective use of medications.
View the Louisiana Medicaid Single PDL (Fee For Service and Managed Care Organizations) (PDF) to see which drugs are covered by your Medicaid benefits.
You can have your prescriptions filled at a network pharmacy. At the pharmacy, you will need to give the pharmacist your prescription and your Louisiana Healthcare Connections ID Card. If you need help finding a pharmacy near you, call us at 1-866-595-8133 (TTY: 711) or use our online Find a Provider tool.
To find a pharmacy that is in the Louisiana Healthcare Connections network, you can use the Find a Provider tool. You can search for a certain pharmacy by name. Or type in your city or zip code and search for pharmacies near you. Only those pharmacies in the Louisiana Healthcare Connections network are listed. If you need help finding a pharmacy, you can also call us at 1-866-595-8133 (TTY: 711).
Prescription Co-Pays
For many members, medications are covered at no cost to you. Some members may need to pay for a small portion of their medications. This is called a “copay.” Louisiana Healthcare Connections pays for the rest of the cost.
The total amount you pay for medicine can’t be more than 5% of your family’s income each month. Once you reach this limit, you won’t have any more copays for the rest of the month.
During the COVID-19 public health emergency, members of Louisiana Medicaid health plans will not pay a co-pay for covered drugs. When the public health emergency ends, the information about co-pays below will apply.
| Prescription Cost | Copay |
|---|---|
| $10.00 or less | $0.50 |
| Between $10.01 and $25.00 | $1.00 |
| Between $25.01 and $50.00 | $2.00 |
| More than $50.01 | $3.00 |
There are no copays for:
- Emergency services
- Family planning supplies
- Certain preventive medications
There are no copays for members who are:
- Pregnant
- Children under the age of 21
- In a long-term care facility
- In hospice care
- Native Americans
- Alaskan Eskimos
- Home and Community Based Waiver recipients
- Eligible for Medicaid due to breast or cervical cancer