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Pharmacy Services

When rendering services, Indiana Health Coverage Programs (IHCP) providers must be aware of the IHCP program in which an IHCP member is enrolled. For members enrolled in the Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier Healthwise managed care programs, it is also important to identify the managed care entity (MCE) with which the member is enrolled.

Pharmacy Benefit Management

Select the link associated with the program/health plan with which the member is enrolled to see applicable pharmacy benefit information, such as Preferred Drug Lists (PDLs) and drug prior authorization (PA) criteria.

Fee-for-Service Programs:

Managed Care Programs:

  • Anthem – HIP, Hoosier Healthwise and Hoosier Care Connect
  • CareSource – HIP and Hoosier Healthwise
  • MDwise – HIP and Hoosier Healthwise
  • MHS – HIP, Hoosier Healthwise and Hoosier Care Connect
  • UnitedHealthcare – Hoosier Care Connect

Statewide Program Support

Optum Rx provides support for statewide pharmacy policy development, including pharmacy boards and committees, as well as the management of the drug rebate program. For more information, see the Optum Rx Indiana Medicaid website.

Opioid Therapy Management Resources

The Indiana Family and Social Services Administration (FSSA) is making resources for the management of opioid therapy easily available to the provider community. Select the links below for access to these resources:

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