Passport Health Plan Medicaid - Louisville, Kentucky
Medicare Advantage Kentucky
Kentucky Medicaid
Kentucky Healthcare
Passport Advantage - Medicare Part D
Pharmacy Benefit Management
Prescription Drug Plan for Medicare
Centers for Medicare & Medicaid Services (CMS)
Kentucky Health Plan Medicaid
Kentucky Prescription Drug Coverage
Pennsylvania Health Plan Medicaid - Keystone Mercy Health Plan Pennsylvania Health Plan Medicaid - AmeriHealth Mercy Health Plan

Medicaid, Kentucky, Medicare, Medicare Advantage, Passport, Health, Plan, Members, Medicare Part D, Centers for Medicare & Medicaid Services (CMS), AmeriHealth Mercy, Perform Rx, Providers, Healthcare, Medical Assistance, Transition Policy, Prior Authorization Process, Pharmacy Network, Drug Formulary, Medication Therapy Management, Enroll, Enrollment, Premiums, Coinsurance, Deductable, Coverage Gap, Eligibility, Co-insurance, Copay/copayment, Dual eligible, Emergency care, Evidence of Coverage (EOC), Generic drugs, Medically necessary services, Medicare Modernization Act (MMA), Medicare Part A, Medicare Part B, Over the Counter (OTC) Drugs, Practitioner, Primary Care Provider (PCP), Summary of Benefits, Urgent care, Special Needs Plan, SOBRA - Poverty level pregnant women and children, TANF - Temporary Assistance to Needy Families, SSI without Medicare - Individuals who are medically needy, aged, blind and disabled, SSI with Medicare - Individuals receiving Supplemental Security Income and Medicare benefits, CHIP - Children of families eligible for Kentucky Children's Health Insurance Program (KCHIP). Eligibility for KCHIP is based on the family's income, Foster Care - Children placed in out-of-home care by the state of Kentucky, Presumptive Eligibility - Temporary benefits for expectant mothers, Welfare, Medical Assistance

Counties
Breckinridge, Marion, Bullitt, Meade, Carroll, Nelson, Grayson, Oldham, Hardin, Shelby, Henry, Spencer, Jefferson, Trimble, Larue, Washington Kentucky Hospitals BAPTIST HOSPITAL EAST BAPTIST HOSPITAL NORTHEAST BRECKINRIDGE MEMORIAL HOSPITAL CARDINAL HILL REHAB HOSPITAL CARITAS MEDICAL CENTER CARROLL COUNTY MEMORIAL HOSPITAL CAVERNA MEMORIAL HOSPITAL EPHRAIM MCDOWELL REG MED CENTER FLAGET MEMORIAL HOSPITAL FRAZIER REHAB CENTER HARDIN MEMORIAL HOSPITAL HARRISON COUNTY HOSPITAL HEALTHSOUTH CENTRAL KY JEFFERSON ALCOHOL & DRUG ABUSE CENTER JEWISH HOSPITAL JEWISH HOSPITAL MC-EAST JEWISH HOSPITAL-SHELBYVILLE KINDRED HOSPITAL LOUISVILLE KOSAIR CHILDREN'S HOSPITAL NEW HORIZONS MEDICAL CENTER NORTON AUDUBON HOSPITAL NORTON HOSPITAL NORTON SOUTHWEST HOSPITAL NORTON SUBURBAN HOSPITAL SOUTHERN INDIANA REHAB HOSP SPRING VIEW HOSPITAL ST LUKE HOSPITAL EAST ST LUKE HOSPITAL WEST TAYLOR REGIONAL HOSPITAL THE JAMES B HAGGIN MEMORIAL HOSPITAL THE KINGS DAUGHTER'S HOSPITAL TWIN LAKES REGIONAL MEDICAL CENTER UNIVERSITY OF LOUISVILLE HOSPITAL

Home > Passport Health Plan > Pharmacy > Glossary of Key Terms

PRIOR AUTHORIZATION (PA):
	Obtaining approval for a particular service or medication before it is provided.

DRUG LIST:
	A comprehensive list of clinically efficacious and cost-effective drug products, identified and selected by a group of knowledgeable and duly licensed clinicians, to be utilized by the Plan in order to deliver a high quality of care to members while containing costs.

PHARMACY BENEFITS MANAGER (PBM):
	An entity contracted with PHP to provide pharmacy services (including performing prior authorization evaluations).

PerformRx:
	Pharmaceutical network for Passport Health Plan

AB-RATED GENERIC:
	A pharmaceutical product rated in the Federal Food and Drug administration Orange Book as being equivalent to the innovator brand product.

GENERIC SUBSTITUTION:
	Dispensing a generic drug in place of a brand-name medication.

GENERIC DRUG:
	Chemically equivalent copy designed from a brand-name drug whose patent has expired.

NON-EQUIVALENT DRUG PRODUCT FORMULARY:
	A list of drug(s) for which generic substitution is not required.

THERAPEUTIC INTERCHANGE:
	The dispensing of a drug product different from that which is prescribed, but which is deemed to be therapeutically equivalent to the original product prescribed.

STEP-THERAPY PROTOCOL:
	A step-by-step set of directions that identifies the progression of drug therapy from first line therapy to the most aggressive drug therapy.