Pharmacy information and tools
Healthy Blue will administer pharmacy benefits for enrolled members. IngenioRX* is the pharmacy benefits manager.
Please refer to the Louisiana Medicaid Single PDL (Fee For Service and Managed Care Organizations) when prescribing for these members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most-commonly-prescribed therapeutic categories.
Though most medications on the PDL are covered without prior authorization, a few agents will require you to contact our Pharmacy department for authorization.
Prior authorizations by phone:
You can reach our Pharmacy department at 844-521-6942 between 7 a.m. and 7 p.m. Central time, Monday through Friday, and 9 a.m. to 1 p.m. Central time on Saturday. However, we are a 24-hour service. Calls received after hours are handled by the Pharmacy’s Second Level staff.
Prior authorizations by fax:
You can also fax your prior authorization request to our Pharmacy department:
Retail prior authorization:
Healthy Blue Dual Advantage
Please refer to the formulary when prescribing for Medicare members. Though most medications on the formulary are covered without prior authorization, a few agents will require you to obtain an authorization. For Medicare Part B, contact the Provider Services department at 844-521-6942 between 7 a.m. and 7 p.m. Central time, Monday through Friday, and 9 a.m. to 1 p.m. Central time on Saturday.
For Medicare Part D, contact:
IngenioRx Provider Services at:
Medicare Part D Rx coverage determinations and appeals
Providers can send a request for a prescription coverage determination for a Medicare plan via electronic prior authorization (ePA) rather than fax or phone by submitting the request from the ePA website:
Healthy Blue Dual Special Needs Plan (D-SNP)
The Healthy Blue Dual Special Needs Plan (D-SNP) offers a variety of benefits designed to help keep your patients healthy while protecting them from unexpected costs.
- Sample Medicare Advantage Member ID cards
- 2021 Summary of Benefits
- 2021 Evidence of Coverage
- 2021 Comprehensive Formulary
- 2020 Summary of Benefits
- 2020 Evidence of Coverage
- 2020 Comprehensive Formulary
- Medicare Advantage - Request for Authorization: Psychological Testing
- Healthy Blue Dual Advantage Provider Authorization Form
Healthy Blue Medicaid formulary
The medications included in the Healthy Blue formulary are reviewed and approved by the Louisiana Department of Health, which includes practitioners and pharmacists.
Medications not listed in the formulary are considered to be non-formulary and are subject to prior authorization.
Some medications listed may have additional requirements or limitations of coverage. These requirements and limits may include prior authorization, quantity limits, age limits, or step therapy.
Additionally, if a medication is available as a generic formulation, this will be the Healthy Blue preferred agent unless otherwise noted. If you have any questions about coverage of a certain product, please contact us at 844-521-6942.
Search for name brand and generic drugs that are on your formulary:
*IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Healthy Blue.