To find a pharmacy near you, use our Online Pharmacy Search tool.
For a list of drugs covered under your patient’s plan, step therapy and prior authorization criteria, and information about coverage determination requests, view or download a copy of the documents below.
- Meridian Prefered Drug List (PDF) Last updated 4/7/2022
- Illinois Formulary Quarterly Summary (PDF) Last updated 4/1/2022
- To submit a medication prior authorization, use covermymeds or fax the Medication Prior Authorization Request Form (PDF) to 855-580-1695
- March 2022 - IL Medicaid Formulary Negative Change – Syringe and Ozobax Criteria Update (PDF)
- March 2022 - IL Medicaid Formulary Negative Change – Inhaler UM Criteria Update (PDF)
- February 2022 - Preferred Drug List Updates (PDF) *Updated 3/9/22
- October 2021 - IL Medicaid Formulary Negative Change - Fluoxetine (PDF)
- May 2021 - IL Medicaid Formulary Negative Change - Tier 4 Supplemental (PDF)
- May 2021 - IL Medicaid Forlumary Negative Change (PDF)
- March 2021 - IL Medicaid Formulary Updates (PDF)
- March 2021 - IL Medicaid Formulary Notice of Negative Change (PDF)
- February 2021 - IL Medicaid Formulary Updates (PDF)
- January 2021 - IL Medicaid Formulary Updates (PDF)
- December 2020 - IL Medicaid Formulary Updates (PDF)
- November 2020 - IL Medicaid Formulary Updates (PDF)
- October 2020 - IL Medicaid Formulary Updates (PDF)
- Sept 2020 - IL Medicaid Formulary Updates (PDF)
- June 2019 - Notice of Formulary Changes: Test Strips and Meters (PDF)
- May 2019 - Anticonvulsant Formulary Change (PDF)
- April 2019 - Notice of Formulary Changes: Updates to Antiretroviral Class (PDF)
Meridian utilizes CVS Caremark as its Pharmacy Benefit Manager (PBM). The PBM provides Meridian members and providers with a pharmacy network, pharmacy claims management services, and pharmacy claims adjudication. Member eligibility is determined prior to authorizing any drug benefit.
Meridian offers prescription Provider Support at 855-580-1688. Meridian providers may also speak with a clinical pharmacist regarding any pharmaceutical, medication administration or prescribing issues.
Medicaid members have both prescription and specific over-the-counter medication coverage. All providers must prescribe from within the drug formulary unless a drug prior authorization is obtained. There are also a few specialized medications in the drug formulary identified as requiring a prior authorization.
To prescribe a drug that requires prior authorization and/or a drug is not on the preferred drug list, providers can submit a request using covermymeds or complete a Medication Prior Authorization Request Form (PDF). These forms can be faxed to 855-580-1695. In emergency situations, please phone 855-580-1688.
If prior authorization is not obtained in advance, the member will not be able to fill the prescription at the pharmacy, causing a delay in obtaining needed medication.
For members struggling with opioid addiction, it is important to provide the right treatment at the right time. Go to the CDC Website for resources that may help in identifying the appropriate treatment.
Meridian partners with Affinity Patient Coordination to provide pharmacist-driven care coordination that assists members in managing their medications. Additionally, members who take six or more medications may be able to participate in a pill pack program to get their medications delivered right to their home