Medication Coverage

General Medication Coverage Resources

  • NYS Medicaid Managed Care and Family Health Plus Pharmacy Benefit Information Website. Provides easy access for members and providers looking for information on the drugs and supplies covered by different Medicaid and Family Health Plus health care plans.
  • Specialty Pharmacies help patients and medical providers with ordering  medications, prior authorization, counseling patients about use, and providing treatment adherence support.
  • CoverMyMeds is a free web based service that helps physicians and pharmacists complete Prior Authorization and other insurance coverage determination forms for any drug and almost all drug plans.

Resources to help resolve medication coverage problems or file a complaint

  • Contact the NYS Department of Health Medicaid Pharmacy Program at ppno@health.state.ny.us.
  • NYS Law A05502B prohibits health insurance companies from mandating mail order pharmacy. If the consumer does not have a clear option, a complaint can be filed through Attorney General’s Health Care Consumer’s Help Line 1-800-342-3736.

Assistance with Cost of Medications & Copays

Pharmaceutical Patient Assistance Programs

Private Patient Assistance Programs

Prescription Assistance 360

Partnership for Prescription Assistance Programs. Brings together America’s pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups to help qualifying patients without prescription drug coverage get free or low-cost medicines through the public or private program that’s right for them.

Patient Access Network (PAN). Independent non-profit organization that provides assistance to under-insured patients for their out-of-pocket expenses for life-saving medications. Has Hep B & Hep C assistance! You can view and distribute this brochure about PAN services for Hep B & C patients.Medications covered:

NeedyMeds. Non-profit information resource devoted to helping people in need find assistance programs to help them afford their medications and costs related to health care. Medications covered:

NYCRx. Non-profit organization working to increase access to affordable medications for medically underserved communities. Free Discount Prescription Card and list of partnering health centers with drug discount programs for their patients.

Chronic Disease Fund. Non-profit charitable organization that helps people with chronic disease, cancer and other life-altering conditions obtain the life-savings medications they need. Disease states may open and close throughout the year as funds are diminished or become available.

RxAssist. Comprehensive database of patient assistance programs, as well as news and practical tools.