Approved Drug Benefits
Getting the medications you need
Your doctor has a wide range of approved drugs to choose. 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.
You now have the ability to use the new Formulary Search Tool to find out which medications are on the formulary drug lists. You can search by drug name or drug class. The search tool will show formulary status and if a generic alternative is available. The formularies can change.
Prior Authorization and quantity limits for drugs
Some prescription drugs require prior authorization from Maryland Physicians Care before a pharmacy can fill your prescription. Your provider can complete the applicable Prior Authorization Form and fax it to Maryland Physicians Care Pharmacy Prior Authorization (PA) Unit at 1-866-207-7231, or call the Maryland Physicians Care Pharmacy PA team at 1-800-953-8854.
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 Maryland Physicians Care 24 hours a day at 1-800-953-8854.
The step therapy (ST) program requires certain first-line drugs, generic drugs or other formulary drugs to be prescribed prior to approval of specific second-line drugs. Please refer to the Step Therapy/Prior Authorization Requirements for more detailed information.