Resources

• Preferred Drug List Quick Reference (Effective 12/1/2021) — New Preferred Drug List Quick Reference format to be available soon
• Diabetic Supply List Quick Reference (Effective 10/1/2021)
• Over-the-Counter Drugs
  • Covered (BadgerCare Plus and Medicaid) (Effective 1/1/2021)
  • Covered by HealthCheck "Other Services" (Effective 8/1/2021)
• Wisconsin AIDS Drug Assistance Program (ADAP) Formulary
  • PDF

Other

• Brand Medically Necessary Drugs and Brand Before Generic Drugs (Effective 12/1/2021)
• Covered Active Pharmaceutical Ingredients (APIs) and Excipients (Effective 6/1/2020)
• Diagnosis Restricted Drugs (Effective 12/1/2021)
• Early Refill Drug Utilization Review Drugs (Effective 8/1/2018) COVID—19 Note
• Expedited Emergency Supply Request Drugs (Effective 7/1/2021)
• State and Specialty Pharmacy Drug Reimbursement Rates (Effective 12/1/2021)
• Influenza Vaccine Procedure Codes Reimbursable to Outpatient Pharmacies for Wisconsin Medicaid and
  BadgerCare Plus fee-for-service and Managed Care Members -- November 14, 2014.
• Medications monitored by the Pharmacy Services Lock-In Program (Effective 1/1/2012)
• Numeric Listing of Manufacturers That Have Signed Rebate Agreements (Effective 12/1/2021)
• Opioids Included in the Prescription Fill Limit (Effective 9/1/2013)
• Prospective Drug Utilization Review Alerts (Effective 10/1/2021)
• Quantity Limit Drugs and Diabetic Supplies (Effective 9/1/2021) COVID—19 Note
• Select High Cost, Orphan, and Accelerated Approval Drugs (Effective 10/1/2021)
• Three-Month Supply Drugs (Effective 8/1/2017) COVID—19 Note
• Explanation of Benefits Report (Effective 12/10/2021)
  • EOBs on Denied Claims for November 2021
  • EOBs on Paid Claims for November 2021