Our Pharmacy Benefits

August 31, 2018

An important part of choosing the right health plan for you is understanding the pharmacy benefits of the plan you’re considering. Louisiana Healthcare Connections covers certain prescription drugs and over-the-counter medicines when they are prescribed by a doctor in our network.

Our members enjoy prescription coverage with little or no co-pay. This means that for most members, medications are covered at no cost. But some members may need to pay a small portion of the cost of their medication – this is called a co-pay. The co-pay amount is never more than $3, and Louisiana Healthcare Connections pays the rest of the cost.

There are no co-pays for:

  • Children under the age of 21
  • Pregnant women
  • Family planning supplies
  • Members in the hospital
  • Alaskan Eskimo or American Indian members

Here are the answers to some of the questions you may have about our pharmacy benefits:

Are all medicines covered?

No, our pharmacy program does not cover all drugs, and some drugs require prior authorization. This means that your doctor will need to submit a request for the medication before prescribing it to you. It is also important to know that some drugs have limitations on age, dosage or amounts – these limits are to make sure your medication is safe and effective.

How can I find out if my medicine is covered?

We have a list called a Preferred Drug List, or PDL, that lists the medicines covered. We work closely with doctors and pharmacists to make sure that medicines used to treat many different conditions and illnesses are covered. Our PDL is updated often to make sure that the medicines on it are safe. You can see our PDL here.

Can I get my medicine at any pharmacy?

You can get your prescriptions filled at any pharmacy in our network. Finding a pharmacy in our network is easy – just use our Find a Provider tool to find one in your city or zip code. You can also call us at 1-866-595-8133, Monday – Friday, 7 a.m. – 7 p.m., for help finding a pharmacy.

Remember: it is important to us that our members have the medicines they need to get – and – stay healthy. We work hard to ensure that all of our members have access to safe, effective medicines.