Please select the state where you practice.

Pharmacy Program

 

MS CHIP

Pharmacy Program 

 

Preferred Drug List (PDL) Search

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by the Mississippi Department of Medicaid.

Click on the link below to see the PDL.


Preferred Drug List

Transitional Care Override Process (PDF 35.45 KB)

90 Day Maintenance List

Mississippi Prior Authorization Form

 

Pharmacy Bulletins

Preferred Diabetic Testing Supplies (PDF 24.53 KB)

Makena Bulletin (PDF 66.14 KB)

 

Pharmacy Prior Authorization Forms

Compound Medications (PDF 73.82 KB) 


MississippiCAN

Pharmacy Program 

 

Preferred Drug List (PDL) Search

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by the Mississippi Department of Medicaid.

Click on the link below to see the PDL.


Preferred Drug List

Transitional Care Override Process (PDF 35.45 KB)

90-Day Maintenance List

Mississippi Prior Authorization Form

 

Pharmacy Bulletins

Preferred Diabetic Testing Supplies (PDF 24.53 KB)

Makena Bulletin (PDF 66.14 KB)

 

Pharmacy Prior Authorization Forms

Compound Medications (PDF 73.82 KB)


UnitedHealthcare Dual Complete® (HMO SNP)
H5008-011