This website is designed to provide 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. While pharmacy benefits and participating pharmacies vary among health plans, all plans maintain their own web sites and customer service call centers.
To use this website, you should first check your health plan identification card and match it to the one presented on this website. By clicking on the appropriate identification card/logo you will be provided with contact numbers and links to your health plan's website. If you do not have your health plan identification card or do not know what health plan you are enrolled in, call the Medicaid Helpline at 1-800-541-2831 from 8am through 8pm, Monday through Friday and from 9am to 1pm on Saturday.
Managed Care Plans
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Affinity Health Plan
Customer Service: For questions regarding policy and coverage information, call 1-866-247-5678.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-364-6331.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-877-432-6793.
AmidaCare
Customer Service: For questions regarding policy and coverage information, call 1-800-556-0689.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-824-0898.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-417-8164.
BCBS of Western New York
Customer Service: For questions regarding policy and coverage information, call 1-877-327-1395.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-866-544-7948.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, fax to 1-866-221-5784.
Capital District Physicians Health Plan
Customer Service: For questions regarding policy and coverage information, call 1-800-388-2994.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-866-693-4611.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-518-641-3784.
EmblemHealth
Customer Service: For questions regarding policy and coverage information, call 1-800-447-8255.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-888-447-7364.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-888-447-7364.
Excellus
Customer Service: For questions regarding policy and coverage information, call 1-800-724-5033.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-788-2949.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-724-5033.
Blue Choice Health Plan General Pharmacy Benefit Information
Blue Choice Health Plan Medicaid Covered Drugs
Blue Choice Health Plan Family Health Plus Covered Drugs
Premier Health Plan General Pharmacy Benefit Information
Fidelis Care
Customer Service: For questions regarding policy and coverage information, call 1-888-343-3547.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-364-6331.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-888-343-3547.
healthfirst
Customer Service: For questions regarding policy and coverage information, call 1-866-463-6743.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-824-0898.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-417-8164.
Health Plus Amerigroup
Customer Service: For questions regarding policy and coverage information, call 1-800-600-4441.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-364-6331.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-454-3730.
Hudson Health Plan
Customer Service: For questions regarding policy and coverage information, call 1-800-339-4557.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-687-0707.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-687-0707.
Independent Health
Customer Service: For questions regarding policy and coverage information, call 1-800-501-3439.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-993-9898.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-247-1466 ext. 5311.
MetroPlus Health Plan
Customer Service: For questions regarding policy and coverage information, call 1-800-303-9626.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-364-6331.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-877-433-7643.
MVP Health Care
Customer Service: For questions regarding policy and coverage information, call 1-800-852-7826.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-922-1557.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, fax to 1-800-376-6373.
Neighborhood Health Providers
Customer Service: For questions regarding policy and coverage information, call 1-800-826-6240.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-824-0898.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-287-0358.
Visiting Nurse Service of New York Choice Health Plans
Customer Service: For questions regarding policy and coverage information, call 1-866-469-7774.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-364-6331.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-877-433-7643.
Total Care
Customer Service: For questions regarding policy and coverage information, call 1-315-634-5555.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-855-772-7085.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-555-8513.
UnitedHealthcare Community Plan
Customer Service: For questions regarding policy and coverage information, call 1-800-493-4647.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-877-305-8952.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-310-6826.
Univera Community Health
Customer Service: For questions regarding policy and coverage information, call 1-800-494-2215.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-788-2949.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-724-5033.
WellCare
Customer Service: For questions regarding policy and coverage information, call 1-800-288-5441.
Pharmacy Help Desk: For pharmacists only, with questions regarding billing issues, claims processing and assistance with claim edits, call 1-800-288-5441.
Prior Authorization: For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call 1-800-288-5441.
Contact Information
For questions regarding your eligibility or to find out which managed care plan you are enrolled in, you may call the Medicaid Helpline at 1-800-541-2831 from 8am through 8pm, Monday through Friday and from 9am to 1pm on Saturday.
If any of the links you click fail to direct you to a specific page, please email PPNO@health.state.ny.us.
- For information on the NY State Medicaid fee for service program visit the New York State Medicaid site.
- For more general information on Medicaid Managed Care and Family Health Plus visit the New York State Managed Care site.
Developed and hosted in partnership with New York State Department of Health.