The ForwardHealth Drug Search tool is designed to help providers identify specific information about a drug covered by Medicaid, BadgerCare Plus, SeniorCare, the Wisconsin Chronic Disease Program, and the HIV Drug Assistance Program. The ForwardHealth Drug Search tool only includes drugs that are billed using a National Drug Code (NDC) on a fee-for-service basis. ForwardHealth uses the National Average Drug Acquisition Cost (NADAC) pricing for the reimbursement of drugs. When there is not a NADAC reimbursement rate available for the drug, ForwardHealth uses the drug’s Wholesale Acquisition Cost (WAC), State Maximum Allowable Cost (SMAC), if available, or the billed amount for reimbursement. Specialty drugs will be reimbursed at the specialty rate. Information in the Drug Search tool is updated regularly. Reimbursement rate information for 340B drugs is not included in the ForwardHealth Drug Search tool. The 340B Drug Pricing Program (340B Program) is a federal government program that requires drug manufacturers to provide outpatient drugs to eligible covered entities at significantly reduced prices.
The information provided by the Drug Search tool does not guarantee coverage or payment. Real-time claim submission provides the most accurate member enrollment, drug coverage and reimbursement determinations. Users should also consult the ForwardHealth Online Handbook for current policies and procedures.
Members with questions about drugs covered by their program may call Member Services at 1-800-362-3002 or consult with their pharmacist or health care provider.
Users may search by any of the following:
At a minimum, users must select a Program or the Over-The-Counter checkbox or enter information in the Search For field and select a Search Category.
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