As a Humana Healthy Horizons® in Ohio member, your pharmacy services are covered by Gainwell, Ohio Medicaid’s Single Pharmacy Benefit Manager (SPBM).

Your prescription coverage

Gainwell covers all Medicaid-covered, medically necessary prescription and over-the-counter (OTC) medications. As a Humana Healthy Horizons in Ohio member, you must use network providers, facilities, and pharmacies to get covered services, including medications. This coverage includes medicine available through the Ohio Department of Medicaid (ODM) Unified Preferred Drug List (PDL).

Gainwell also offers coverage for over-the-counter items.

View the Gainwell member handbook, PDF

Get answers to frequently asked questions about Gainwell and your pharmacy coverage , PDF

Preferred drug list

The ODM Unified PDL is a list of medicine Ohio 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 ODM Unified PDL

If your provider wants you to take medicine that requires prior authorization, he or she will submit a prior authorization request to Gainwell.

Connect with Gainwell

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Value-added benefits

Learn about the extra benefits and services available to Humana Healthy Horizons in Ohio members.

Documents & forms

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