Skip to Main Content
Ready to renew your Medicaid coverage? Explore our step-by-step guide to Medicaid renewal. Here's how
Ready to renew your Medicaid coverage? Explore our step-by-step guide to Medicaid renewal. Here's how

EFFECTIVE APRIL 1, 2022, MERIDIAN MEDICAID PLAN WILL TRANSITION THE PHARMACY BENEFIT MANAGER (PBM) FROM MERIDIANRX TO CVS CAREMARK.

Date: 02/25/22

Thank you for being an essential member of our Meridian Provider Network. Effective April 1, 2022, Meridian Medicaid Plan will transition our Pharmacy Benefit Manager (PBM) from MeridianRx to CVS Caremark. As part of this transition, members will receive a new ID card.

Other changes include 

  • New members will receive a transition fill of up to 90 days for certain medications
  • The Acetaminophen edit has been changed. Pharmacies will now receive a message when the total daily dose of acetaminophen is greater than 4 grams
  • There will be a high-dollar claim limit. For most medications, it will be $3,000 

Exceptions include:

  1. CMV Agents - $4,250
  2. HIV Infection Drug - $10,000
  3. Digestive Enzymes - $10,000
  4. Specialty medications - $10,000
  5. Vivitrol – no limit
  • A new specialty pharmacy list will be utilized.
  • Members with a diagnosis recorded in the pharmacy system of sickle cell, cancer, or palliative care will receive a greater than a 7-day supply of opioids, even if they are opioid-naïve
  • Some bupropion products have been removed from look-back period to identify an opioidnaïve member
  • Additional vaccines (diphtheria, haemophilus, hepatitis, influenza, meningococcal, pneumonia, tetanus, varicella, zoster, etc.) will be available at the pharmacy 

All other pharmacy benefits for Meridian members will remain the same. Active prior authorizations will not be changed.

We appreciate your careful attention to this new information. Please call the pharmacy help desk at 855-580-1688 (TTY: 711) if you have questions.