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 | 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 |