Medicaid preferred drug list wisconsin Wisconsin Medicaid Preferred Drug List Key: All lowercase letters = generic product. For a list of NDCs with similar names, or a list of NDCs by Manufacturer name, enter a minimum of 3 characters in the search field and choose the appropriate search category. Page . For a list of drugs by Drug Class, select a class from the Drug Class drop-down list. INSTRUCTIONS: Type or print clearly. Scroll down to see our Pharmacy & Drug Coverage Info Frequently Asked Questions. Uses PA/DGA Form/Sec. VII Paper PA process only Refer to topic #15937 . VII Paper PA process only Refer to topic #15937 Uses specific Drug PA Form - available department of health services state of wisconsin division of medicaid services wis. Revised 01/13/2025 Effective 01/01/2025 . Instructions: Type or print clearly. VII Paper PA process only Refer to topic #15937 Uses specific Drug PA Form - available Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference E ffective 5/01/2024. Before completing this form, read the Prior Authorization Mar 13, 2025 · Our Partnership members that are not enrolled in Medicare receive their drug benefit through the State of Wisconsin Medicaid program. Alphabetical Listing – Preferred Drugs Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Effective 01/01/2025 . 4 days ago · Diabetic Supply List Quick Reference (Effective 1/1/2025) Over-the-Counter Drugs. For drugs covered under Medicaid, please see the Forward Health Preferred Drug List. of . Page 2 of 14 Brand Before Generic (BBG) Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Form/Sec. 2. Brand Before Generic (BBG) Drug Refer to topic #20077 Monthly Changes to the PDL . Revised: 01/02/06 Leading capital letter = brand name product. Revised 06/10/2022 (Effective 06/01/2022) Page . 10(2) F-01672 (01/2017) FORWARDHEALTH . VIIForm Paper PA process only Refer to topic #15937 . Before completing this form, read the Prior Authorization/Preferred Drug List Wisconsin Medicaid Preferred Drug List Preferred Requires Prior Authorization Preferred Requires Prior Authorization benazepril, HCTZ Aceon Aricept Cognex captopril, HCTZ Altace Exelon enalapril, HCTZ Mavik Namenda fosinopril, HCTZ Univasc/Uniretic Razadyne, ER lisinopril, HCTZ quinapril, HCTZ Preferred Requires Prior Authorization Wisconsin Medicaid, BadgerCare Plus Standard, and Sen iorCare Preferred Drug List – Quick Reference . 3. Uses specific Drug PA Form Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference . admin. VII Paper PA process onlyPaper PA pro Refer to topic #15937 Uses specific Drug PAUses PA/DGA Wisconsin Medicaid Preferred Drug List Key: All lowercase letters = generic product. VIIForm Paper PA process only Refer to topic #15937 Uses specific Drug PA - available via Paper PA 5 days ago · Diabetic Supply List Quick Reference (Effective 1/1/2025) Over-the-Counter Drugs. Revised 04/09/2021 (Effective 04/01/2021) Page . Wisconsin Medicaid, BadgerCare Plus Standard, and Sen iorCare Preferred Drug List – Quick Reference (Effective 06/01/2021) Page . For medication questions, please call the state provider services line at 1-800-947-9627. 10(2) f-02572a (01/2025) forwardhealth prior authorization / preferred drug list (pa/pdl) for immunomodulators, atopic dermatitis – topical instructions Medicaid Plans Back. VII Paper PA process only Refer to topic #15937 Medicaid in Wisconsin; Medicare Counseling; Prior Authorization/Preferred Drug List (PA/PDL) for Non-Preferred Stimulants, Instructions: 01/01/2022 : PDF Jan 7, 2025 · Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Revised 01/07/2025 Effective 01/01/2025 . Admin. Effective 09/01/2024. PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR STIMULANTS AND RELATED AGENTS . See the 2025 Partnership plan documents. 09/09/05 Leading capital letter = brand name product. Brand Before Generic (BBG) Drug Refer to topic #20077 . Monthly Changes to the PDL . The National drug list is for Wisconsin members who receive a health insurance plan from an employer, if they have certain The pharmacy benefit for members of BadgerCare Plus (Standard, Benchmark and Core plans) and Medicaid SSI is managed by the state of Wisconsin. VII Pa per PA process only Refer to topic #15937 Uses specific Drug PA Form - available via Paper PA Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Revised 01/21/2021 (Effective 01/01/2021) Page . VIIForm Paper PA process only Refer to topic #15937Refer to topic #15937 6 days ago · For a list of NDCs by labeler code, enter a minimum of 5 digits for the NDC. 10(2) F-11075 (07/2023) FORWARDHEALTH . PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) EXEMPTION REQUEST . VII Paper PA process only Refer to topic #15937 Uses specific Drug PA Form - available via Paper PA Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Effective 01/01/2025 . Revised 05/24/2021 (Effective 05/01/2021) Page . code § dhs 107. 14. Uses specific Drug PA Form Wisconsin Medicaid Preferred Drug List Preferred Requires Prior Authorization Preferred Requires Prior Authorization benazepril, HCTZ Aceon Aricept Cognex captopril, HCTZ Altace Exelon enalapril, HCTZ Mavik Namenda fosinopril, HCTZ Univasc/Uniretic Razadyne, ER lisinopril, HCTZ quinapril, HCTZ Preferred Requires Prior Authorization Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference . VII Paper PA process onlyvia Paper PA Refer to topic #15937 Uses specific Drug PA Form Division of Medicaid Services F-11097 (09/2019) FORWARDHEALTH . This document contains references to Wisconsin Medicaid Preferred Drug List Key: All lowercase letters = generic product. Monthly Changes to the PDL Uses PA/DGA Form/Sec. PDF; Other Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Revised 1/5/2024Effective 1/01/2024 Page 2 of 14 Brand Before Generic Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Form/Sec. Code § DHS 107. VII Paper PA process only Refer to topic #15937 Uses specific Drug PA Form - available Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Preliminary Effective 07/01/2024. Medicaid Medical Preferred Drug List - January 2024 **Non-preferred product(s) are only available if process exception criteria are met. 8 The following is an alphabetical list of preferred drugs and drugs that require prior authorization on the Wisconsin Medicaid PDL. Brand Before Generic Drug Refer to topic #20077 . VIIForm Paper PA process onlyPaper PA process only Refer to topic #15937 Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference . Revised 01/08/2025 Effective 01/01/2025 . VIIForm Paper PA process only Refer to topic #15937Refer to topic #15937 Nov 6, 2024 · Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Revised 11/06/2024 Effective 1/01/2024. Alphabetical Listing – Preferred Drugs Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference . Before completing this form, read the Prior Authorization/Preferred Drug List (PA/PDL) for Stimulants and Related Agents Completion Instructions, F-11097A. Division of Health Care Access and Accountability Wis. VII Paper PA process only Refer to topic #15937 Uses specific Drug PA Form - available Wisconsin Medicaid Preferred Drug List Key: All lowercase letters = generic product. PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR NON-PREFERRED STIMULANTS . Alphabetical Listing – Preferred Drugs DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN . Alphabetical Listing – Preferred Drugs DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Medicaid Services Wis. VII Paper PA process only Refer to topic #15937 Uses specific Drug PA Form - available Wisconsin Medicaid, BadgerCare Plus Standard, and Sen iorCare Preferred Drug List – Quick Reference Revised 07/13/2021(Effective 07/01/2021) Page 2 of 13 Brand Before Generic Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Form/Sec. Page 3 of 13 Brand Before Generic (BBG) Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Form/Sec. Brand Before Generic Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Fo rm/Sec. Page 3 of 14 Brand Before Generic (BBG) Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Form/Sec. Uses specific Drug PA Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference Effective 07/01/2024. 4. 13. 12. PDF; Other Jan 13, 2025 · Wisconsin Medicaid, BadgerCare Plus Standard, and SeniorCare Preferred Drug List – Quick Reference . Brand Before Generic Drug Refer to topic #20077 Monthly Changes to the PDL Uses PA/DGA Form/Sec. Some medicines are prescribed for more than one condition. This list indicates the common uses for which the drug is prescribed. Covered (BadgerCare Plus and Medicaid) (Effective 10/1/2024) Covered by HealthCheck "Other Services" (Effective 10/1/2023) Wisconsin HIV Drug Assistance Program (HDAP) Formulary. The Preferred Drug List (PDL) is located on the ForwardHealth website. Uses PA/DGA Uses PA/DGA Form/Sec. . Medicaid Plans. cebijh nvi xmt lrjqaj eaihdns xqkmc rhcmr pstj ngvqqmcd tqodbe jtleivj dsawva jtbexn vgzw spyyns