My prescriptions

Covered drugs includes over-the-counter drugs along with ones covered by Medical Assistance.

To receive a covered drug:

• Have your health care provider write a prescription for it
• Take the prescription to a pharmacy in the Medica network

The pharmacist will fill your prescription with a generic version of the drug if one is available. If there's no generic version, the pharmacist will give you a name-brand version.

The most you'll pay in prescription copays is $70 per month. Some mental health drugs and most family planning drugs don't have a copay.

Specialty drugs are used to treat certain complex and chronic health problems. They tend to be very expensive and may need special handling and monitoring.

If you are prescribed a specialty drug, your prescriber will need to send the prescription for it to our preferred specialty pharmacy, Accredo Specialty Pharmacy.*

How to fill a new specialty drug prescription

1. Check the List of Covered Drugs (Formulary) to see if your medication is a specialty drug.
2. Fill your prescription through Accredo Specialty Pharmacy.*
• First time filling a prescription: Call Accredo to set up an account. Have your Medica identification (ID) card ready when you call.
• Refilling an active prescription: Create an account on the Accredo Patient Portal to manage refills.

Accredo Patient Portal

Questions?

Accredo Specialty Pharmacy Customer Service

1-866-544-6817 (toll-free) (TTY: 711)

7 a.m. – 10 p.m. CT, Monday – Friday
7 a.m. – 4 p.m. CT, Saturday

* There are a small number of drugs not available through Accredo Specialty Pharmacy. These drugs may be considered limited distribution by the manufacturer. This means they must be obtained through a different specialty pharmacy.

Your provider typically knows where to send prescriptions for limited distribution drugs, but if you have questions, contact Accredo Specialty Pharmacy.

If your specialty drug is available through Accredo and you fill it at different specialty pharmacy, your drug won't be covered, and you'll be responsible for the entire cost.

Some drugs need approval or prior authorization before you get your prescription filled. Your provider can request prior authorization approval from us. You must get approval from us before you can fill your prescription for these drugs. If you don't, we may not cover the cost.

Prior authorization

It's important for your provider to fill out the form as completely as possible for each drug, and list which medications you have tried and failed. Your provider should include the dosages that you used and the reason why the drugs didn't work (e.g. side effects or effectiveness).

Minnesota uniform form for prescription drug prior authorization (PA) requests and formulary exceptions (PDF)