Approved Medications
Maryland Physicians Care makes it easier for members to find information on the medications available to them. Learn about medications approved under your MPC medical coverage and find links to authorization forms and other resources below.
Pharmacy Copays
Beginning May 1, 2024, Maryland Medicaid will require all HealthChoice program MCO health plans to start charging prescription copayments. This change will apply to MPC members aged 21 and over and excludes pregnant women, people of Native American Indian heritage, and family planning medications. The copays will be $3 for non-preferred /brand medications and $1 for preferred/generic. A 90-day supply of maintenance medications will be a $3 copayment. If you have any questions, please contact our Customer Services Department at 800-953-8854.
Getting Medications You Need
Your doctor has a wide range of approved drugs to choose from. Our list includes drugs available to you through a prescription from your doctor. This list also includes generic prescription drugs and some brand-name drugs. Please ask your doctor to consider a drug from the generic prescription drug list if it meets your medical needs.
- Approved Drug List (PDF)
- Approved Drug List Updates (PDF)
- Over-The-Counter Covered Medications (PDF)
Help Is Here!
Members can access the Formulary Search Tool to find information about medications on the formulary drug list. This search tool shows the formulary status for approved medications and if a generic alternative is available. The formularies can change, so members are encouraged to use the formulary search tool and talk to their doctor if they have any questions about their options.
Prior Authorization and Quantity Limits for Drugs
Some prescription drugs require prior authorization from MPC before a pharmacy can fill your prescription. Your provider can complete the appropriate prior authorization form and submit it to MPC.
If a drug, that is not on this list, is needed in an emergency, a limited supply will be given. Your doctor or pharmacist can call MPC 24 hours a day at 1-800-953-8854
Step Therapy
The Step Therapy (ST) program requires certain first-line drugs, generic drugs, or other formulary drugs to be prescribed before approval of specific second-line drugs. Please refer to the Step Therapy/Prior Authorization Requirements for more detailed information.
