Requests for "Brand Necessary" medications will be considered a nonformulary medication request and will require authorization. Supplemental Formulary . Contact the plan for more information. The Formulary, pharmacy network, and/or provider network may change at any time. This formulary is current as of August 1, 2020. Payment will only be made for FDA approved drugs and drugs not excluded from payment by Medical Assistance. Copays Members 21 years of age and older: generic drugs on formulary are $1; brand drugs on formulary are $3 per prescription. For an updated formulary, please contact us. Call Member Services at 1-800-392-1147 TTY users call 711 or 1-800-654-5984 Or visit our website at GatewayHealthPlan.com 2020 Medicaid Gateway ONLY covers Food and Drug Administration (FDA) approved drugs. This document includes a list of the drugs (formulary) for our plan which is current as of 11/25/2020. Quickly and easily search for the medications you need. The Pennsylvania Medical Assistance Program Fee-For-Service Preferred Drug List (PDL) is supported by Change Healthcare. Gateway Health Alliance (Gateway) is a managed care company dedicated to partnering with area employers in order to provide them with affordable, well managed health insurance. Gateway is organized as a free-standing corporation, operating separately from the hospitals, physician practices, pharmacies, mental healthfacilities and other providers. *Statewide Preferred Drug List (PDL) Effective January 1, 2020* As of January 1, 2020, all managed care organizations (MCOs) that provide outpatient drug services to Medicaid beneficiaries in Pennsylvania and the State Fee-for-Service (FFS) program will use the same Preferred Drug List (PDL). Pennsylvania is improving the way we provide services to: • People enrolled in both Medicare and Medicaid (Medical Assistance); • People enrolled in Medicaid waivers for physical disabilities and older adults; and • Medicaid-eligible people who live in a nursing home. Louisiana Medicaid Preferred Drug List (PDL)/Non-Preferred Drug List (NPDL) • The PDL is a list of over 100 therapeutic classes reviewed by the Pharmaceutical & Therapeutics (P&T) committee. The Gateway Health (Gateway) formulary is a list of FDA-approved covered medications which have been reviewed and approved by our Pharmacy and Therapeutics (P&T) Committee and the Pennsylvania Department of Human Services (DHS). Formulary Prior Authorization from the Health Plan. The Gateway Health Request for Nonformualry Drug Coverage Form must be submitted with sufficient documentation to substantiate medical necessity of the brand name medication. The P&T Committee is made up of actively 2020 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Medicaid Provider Updates: Dec 2020 Notice of Medicaid Policy Updates For Jan 1: Nov 2020 Notice of Medicaid Policy Updates For Dec 21: Nov 2020 Physicians are encouraged to prescribe generic medications whenever clinically appropriate. 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