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New PBMs for Louisiana Medicaid Health Plans Effective October 1, 2025

Date: 08/22/25

On October 1, 2025, Healthy Louisiana will discontinue its single Pharmacy Benefit Manager (PBM) for Medicaid health plans, and pharmacy benefits for each Medicaid health plan will be managed by the PBMs listed below. The Louisiana Department of Health, the Medicaid health plans, and all involved PBMs are working together to ensure a smooth transition for both members and pharmacies. Please keep this notice for future reference.

  • Before October 1, 2025, continue to operate as normal with Prime Therapeutics as the Healthy Louisiana single PBM.
  • Prior Authorizations: Existing prior authorizations will be transferred to the new PBMs and will continue to be honored.
  • Networks: Confirm your pharmacy’s network status with each PBM listed below.
  • New ID Cards: All affected Medicaid enrollees will be mailed new health plan ID cards containing updated PBM details. During the transition, some Medicaid enrollees may present ID cards with incorrect PBM details. You can refer below for the correct information.
  • Fee-for-Service: Medicaid enrollees covered under the fee-for-service program are not affected by this transition.

Health Plan

PBM Name

RxBIN

RxPCN

RxGroup

Pharmacy Help Desk

Retail Pharmacy Prior Authorization Requests

Before October 1, 2025:

All LA Medicaid Health Plans

Prime Therapeutics

025986

1214172240

LAMCOPBM

1-800-424-1664

Phone: 1-800-424-1664

Fax: 1-800-424-7402

October 1, 2025, and after:

Aetna Better Health
of Louisiana

CVS Caremark

610591

MCAIDADV

RX881J

1-855-364-2977

Phone: 1-855-242-0802

Fax: 1-844-699-2889

AmeriHealth Caritas Louisiana

PerformRx

019595

06030000

None

Member: 1-866-452-1040

Pharmacy: 1-800-684-5502

Phone: 1-800-684- 5502

Fax: 1-855-452-9131

Healthy Blue

Carelon Rx

020107

LA

RX8482

Member: 1-833-485-6238

Pharmacy: 1-833-485-6236

Phone: 1-844-521-6942

Fax: 1-855-592-0978

Humana Healthy Horizons in Louisiana

Humana Pharmacy Solutions, Inc.

610649

03191502

LAM01

Member: 1-800-448-3810

Pharmacy: 1-833-252-1677

Phone: 1-800-555-2546

Fax: 1-877-486-2621

Louisiana Healthcare Connections

Express Scripts, Inc.

003858

MA

2ENA

Member: 1-866-595-8133

Pharmacy: 1-833-750-4451

Phone: 1-866-595-8133

Fax: 1-833-645-2733

UnitedHealthcare Community Plan

Optum Rx

610494

4041

ACULA

1-866-328-3108

Phone: 1-800-310-6826

Fax: 1-866-940-7328