Medicaid Pharmacy Benefits | Healthy Blue Kansas

Getting your prescriptions in Kansas is easy

Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. Remember to show the pharmacy your Healthy Blue member ID card.

Find a pharmacy 

Have questions about your pharmacy benefits?

Call Pharmacy Member Services, 24 hours a day, seven days a week at 833-838-8558 (TTY 711).

Discover more about your drug coverage

Did you know Kansas has a list of preferred and non-preferred drugs chosen for quality and effectiveness? It's called the KDHE Preferred Drug List (PDL).

Most preferred drugs on the PDL do not require preapproval. Non-preferred drugs on the PDL will require preapproval. This means your doctor must get approval from us. Since the PDL can change at any time, be sure to check back here for updates.

KDHE Preferred Drug List (English) 

Some medicines need preapproval, or an okay from us, before they can be filled. For those medicines, your doctor must submit a preapproval request before you can fill your prescription. They can do this by calling Provider Services at 833-838-2595 (TTY 711) or by faxing the request to: 

877-941-9901 Fax for retail requests; or
877-941-9841 Fax for Physician Administered Drug requests.

Preapprovals are necessary for drugs that: 

Have the potential for serious side effects.
Should be prescribed only for specific usage.
Have a high misuse or abuse potential.
May cost more than other preferred drugs.

The preapproval process helps us make sure you’re taking medicines safely and correctly.   

You may also need preapproval when: 

Requesting a higher dosage than recommended.
The drug is part of a step-therapy treatment plan.
Requesting a brand-name drug that already has an FDA-approved generic version.

The Healthy Blue Kansas formulary is a list of all brand-name and generic drugs available in your plan. The formulary will show preferred and non-preferred drugs, preapproval requirements, and drug limitations. Use the formulary to search for drugs by:

Typing the name of the drug in the search box.
Using the A–Z list to search by the first letter of the drug name.
Selecting the therapeutic class of the drug.

If you need a drug that isn’t listed on he Healthy Blue Kansas formulary, you or your representative can request a formulary exception at submitmyexceptionreq@healthyblue.com. 

Search the Healthy Blue Kansas formulary