Approved Drug Benefits
Maryland Physicians Care has a wide selection of approved drugs. The approved drug list includes generic prescription drugs and some brand-name drugs. Please consider a drug from the generic prescription drug list if it meets your patient’s medical needs.
- Preferred Drug List (PDF)
- Use the Formulary Search Tool through Express Scripts for real-time coverage information
- Monthly Formulary Updates (PDF)
- Over-The-Counter Covered Medications (PDF)
- Behavioral Health Information
- Preferred Diabetic Pen Needle Coverage (PDF)
- Preferred Asthma Controller Medication List (PDF)
Prior Authorization for Medications
For a complete list of prior-authorization forms, click here.
Step Therapy Requirements
Medications that require Step Therapy (ST) require trial and failure of preferred formulary agents prior to their authorization. If the prerequisite medications have been filled within the specified time frame, the prescription will automatically process at the pharmacy. Prior Authorization will be required for prescriptions that do not process automatically at the pharmacy. Click on the Step Therapy Requirements Guide (PDF) to learn more.
HIV Carve-in Benefit Information
As of January 1, 2020, all HIV medications were carved in as a pharmacy benefit from Maryland Medicaid to be managed by Medicaid recipients’ individual Managed Care Organization (MCO).
For additional information on HIV medications and prior authorization forms, click here.
- HIV Drug Chart Quick Reference Guide (PDF)
- HIV Carve-in Benefit Frequently Asked Questions (FAQs) (PDF)