How do you get your prescriptions?
- When your provider gives you a prescription, ask if it needs prior authorization (see page 14). If the provider says “yes”, you could wait longer once you arrive at the pharmacy. If you do not want to wait, ask for another medicine that does not need prior authorization.
- Go to a pharmacy that is signed up with Passport Health Plan and give them your prescription. To find out if a pharmacy is signed up with Passport Health Plan, call Member Services or go to www.passporthealthplan.com.
- Show the pharmacy your Passport Health Plan ID card.
General information about your prescriptions:
- You will get no more than a 30 day supply of any drug at one time.
- If a generic form of the medicine is available, it will be given to you as long as it’s a covered benefit.
- Some over-the-counter medicines may be paid for if your provider writes you a prescription. The medicine must be part of your treatment plan.
- You may be asked to pay a small amount (copay) for each prescription, including over-the-counter medicines. See the “Copays and Premiums” sheet in the back of the Handbook.
- Some medicines may need prior authorization or step therapy. Prior authorization means the medicines must be approved before you can get them. Step therapy is a step-by-step approach used to find which medicine works best for you.
Where can you find a list of covered drugs?
The list of medicines we pay for is on our website at www.passporthealthplan.com. You may also call Member Services for this list. New medicines come out all the time, so the list may change.
What medicines are NOT covered by Passport Health Plan or Medicaid (KyHealth
- Cosmetic products. For example: hair removal, hair growth products, or skin blemish creams.
- Fertility drugs – medicines to help you get pregnant.
- Medicines used for research that are not approved by the Food and Drug Administration (FDA).
- Medicines that are not medically necessary.
- Erectile dysfunction drugs (Viagra, Levitra and Cialis).
- Herbal supplements.
- Stop-smoking products. Other stopsmoking help may be available. Please call Care Coordination at 1-877-903-0082.
What if you have Medicare and need a prescription?
If you have Medicare and need a prescription go to the “If You Have Medicare and Passport Health Plan” section on page 9 of the Handbook.