Pharmacist discusses medication with patient

Louisiana Medicaid: Prescription coverage

Humana Healthy Horizons in Louisiana members are eligible for pharmacy benefits. Prime Therapeutics State Government Solutions Pharmacy Benefits Management Program provides pharmacy benefits for Louisiana Medicaid recipients. This coverage includes prescription medications and certain over-the-counter medications with a written order from a Humana Healthy Horizons provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.

Preferred Drug List

The Louisiana Department of Health (LDH) Single Preferred Drug List (PDL) is a list of medicine Louisiana Medicaid recipients can use if prescribed. A Pharmacy and Therapeutics (P&T) Committee recommends medicine to include on or remove from the PDL. Medicine on the PDL is identified as preferred or nonpreferred and includes information about prior authorization requirements.

Review the current LDH Single PDL

Find a pharmacy

Prime Therapeutics has a large network of pharmacies at https://www.lamcopbmpharmacy.com/find-a-pharmacy. There is also a full PDF directory on the website, or one can be mailed to you by calling the Member Pharmacy Call Center at 1-800-424-1664.

At a pharmacy

When visiting a pharmacy, please show your Humana Healthy Horizons® in Louisiana member ID card.

If you have any questions, please call the Member Pharmacy Help Desk: 1-800-424-1664.

You received your Humana Healthy Horizons in Louisiana member ID card in the mail. You also can see a copy of it in your secure MyHumana account. Don’t have a secure MyHumana account? Create your account today.

Copays

Some adult members will need to pay a small copay for their prescriptions. The co-pays for medication are as follows:

Copay calculated state payment

Copayment amount
$0.00
$0.50
$1.00
$2.00
$3.00

Calculated state payment
$5.00 or less
$5.01 to $10.00
$10.01 to $25.00
$25.01 to $50.00
$50.01 or more

There will be no copay for members who are, for example:

  • Less than 21 years of age
  • Pregnant
  • Receiving emergency services
  • Living in long-term care facilities or other institutions
  • Federally-recognized Native Americans or Alaskan Eskimos

Over-the-counter health and wellness

Humana Healthy Horizons in Louisiana members have a $25 per month allowance for over-the-counter (OTC) health and wellness items, and these items:

  • Will be sent by UPS, FedEx, or the U.S. Postal Service in 10–14 working days after the order is made
  • Are generic versions of brand-name medicine and will be the same as a brand-name medicine in:
    • Dosage
    • Effectiveness
    • How to take the medicine
    • How the medicine works
    • Quality
    • Safety
    • Stability
    • Strength

Examples of available OTC items include:

  • Pain relievers
  • Diaper rash cream
  • Cough and cold medicine
  • First-aid items

View a full list of available OTC health and wellness items:

Over-the-Counter Health and Wellness Catalog and Order Form – English

Over the Counter Health and Wellness Catalog and Order Form – Spanish

If you have questions about this mail-order service, call CenterWell Pharmacy™ at 1-855-211-8370 (TTY: 711), Monday – Friday, 7 a.m. – 10 p.m. and Saturday, 7 a.m. – 5:30 p.m.

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