Resources

• Revised 5/19/2023: Preferred Drug List Quick Reference (Effective 5/1/2023)
  • Preferred Drug List Quick Reference (Effective 6/1/2023)
• Diabetic Supply List Quick Reference (Effective 7/1/2022)
• Over-the-Counter Drugs
  • Covered (BadgerCare Plus and Medicaid) (Effective 5/1/2023)
  • Covered by HealthCheck "Other Services" (Effective 5/1/2023)
• Wisconsin AIDS Drug Assistance Program (ADAP) Formulary
  • PDF

Other

• Brand Medically Necessary Drugs and Brand Before Generic Drugs (Effective 5/1/2023)
• Covered Active Pharmaceutical Ingredients (APIs) and Excipients (Effective 6/1/2020)
• Diagnosis Restricted Drugs (Effective 1/1/2023)
• Early Refill Drug Utilization Review Drugs (Effective 12/1/2022)
• Expedited Emergency Supply Request Drugs (Effective 1/1/2023)
• State and Specialty Pharmacy Drug Reimbursement Rates (Effective 5/1/2023)
  • Effective 6/1/2023 — State and Specialty Pharmacy Drug Reimbursement Rates
• 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 5/1/2023)
  • Effective 6/1/2023 — Numeric Listing of Manufacturers That Have Signed Rebate Agreements
• Prospective Drug Utilization Review Alerts (Effective 12/1/2022)
• Quantity Limit Drugs and Diabetic Supplies (Effective 5/1/2023)
  • Effective 6/1/2023 — Quantity Limit Drugs and Diabetic Supplies
• Select High Cost, Orphan, and Accelerated Approval Drugs (Effective 2/1/2023)
• Revised 1/12/2023: Three-Month Supply Drugs (Effective 12/8/2022)
• Explanation of Benefits Report (Effective 5/10/2023)
  • EOBs on Denied Claims for April 2023
  • EOBs on Paid Claims for April 2023