Pharmacy and Prescription Drugs
You get prescription drugs at no cost to you. We cover your medically necessary medicines when filled at a Molina network pharmacy. We also cover some over-the-counter (OTC) medicines with a prescription from your provider.
Molina is required to use the Nebraska Medicaid state-prescribed list of covered drugs called Preferred Drug List (PDL). A team of doctors and pharmacists update this regularly. They use recommendations from national organizations and experts to make decisions on preferred and non-preferred drugs. They want to make sure the drug on the list is safe and helpful for you. And that it is cost-effective for the Heritage Health program.
The pharmacy program does not cover all medications.The formulary lists all the drugs covered by your plan. The PDL gives you facts about a drug and lists any restrictions. The PDL also includes both generic and brand-name drugs. Generic drugs are drugs that have the same dosage, safety, strength and intended use as a brand-name drug. They usually cost less than brand-name drugs.
Certain drugs on the PDL, and those not on our PDL, require a Prior Authorization (PA). For those drugs that require PA, your provider will need to send us a Prior Authorization Request. Prior Authorization requests for covered services will be reviewed and approved if medically necessary to treat your condition.
To fill your prescriptions, you must use a Molina network pharmacy. Be sure to take your member ID card with you and remember to fill your prescriptions before you travel out of state.
You can see all the covered drugs on the formulary at:
Nebraska Medicaid program | PDL | PDL Listings (fhsc.com)
Formulary Searchable Tool
The formulary is subject to change so please check the formulary list when you need to fill or refill a medicine.
Find a Molina Healthcare provider or pharmacy.
It’s important to choose the right providers and pharmacies when you or a loved one needs care. Use our Molina online search tools to find network providers (find a doctor or facility) and pharmacies (find a pharmacy). You can search by name, specialty, language and more.
To find a full list of network providers, see our Provider Directory or you can contact Member Services.