Resources

• Preferred Drug List Quick Reference (Effective 5/1/2025)
• Preferred Drug List Quick Reference (Effective 4/1/2025)
• Diabetic Supply List Quick Reference (Effective 5/15/2025)
• Diabetic Supply List Quick Reference (Effective 1/1/2025)
• Over-the-Counter Drugs
  • Covered (BadgerCare Plus and Medicaid) (Effective 4/1/2025)
  • Covered by HealthCheck "Other Services" (Effective 4/1/2025)
• Wisconsin HIV Drug Assistance Program (HDAP) Formulary
  • PDF

Other

• Brand Medically Necessary Drugs and Brand Before Generic Drugs (Effective 4/1/2025)
  • Effective 5/1/2025 — Brand Medically Necessary Drugs and Brand Before Generic Drugs
• Covered Active Pharmaceutical Ingredients (APIs) and Excipients (Effective 6/1/2020)
• Diagnosis Restricted Drugs (Effective 3/1/2025)
  • Effective 5/1/2025 — Diagnosis Restricted Drugs
• Early Refill Drug Utilization Review Drugs (Effective 12/1/2022)
• Expedited Emergency Supply Request Drugs (Effective 1/1/2025)
• State and Specialty Pharmacy Drug Reimbursement Rates (Effective 5/1/2025)
• State and Specialty Pharmacy Drug Reimbursement Rates (Effective 4/1/2025)
• 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 4/1/2025)
  • Effective 5/1/2025 — 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 4/1/2025)
  • Effective 5/1/2025 — Quantity Limit Drugs and Diabetic Supplies
• Select High Cost, Orphan, and Accelerated Approval Drugs (Effective 4/1/2025)
• Three-Month Supply Drugs (Effective 12/1/2024)
• Explanation of Benefits Report (Effective 4/10/2025)
  • EOBs on Denied Claims for March 2025
  • EOBs on Paid Claims for March 2025