Did you know?
Meridian members have access to the MeridianRx Mobile App. With the MeridianRx Mobile App, you can:
Click here to learn more and download this free app!
Here are some common questions from MHP members:
I need to fill a prescription. What should I take to the pharmacy?
Take both your Meridian Health Plan and MiHealth cards to the pharmacy. You should also take personal identification, like a driver's license or state issued identification card, with your picture on it.
MHP does not charge a co-payment for covered medications.
Michigan Medicaid covers some medicine. MHP Members over 21 may have a co-pay if the doctor prescribes one of these medicines. Your co-pay will be $1.00 for generic medicine and $3.00 for brand name medicine. The pharmacy can tell you if a medicine is generic or brand name.
If I paid cash for a medication, how do I receive reimbursement?
If you have paid cash for a medication, please fill out the form below and attach the medication label name, pharmacy receipt and a note describing the reasons for paying cash.
What is a Drug Formulary?
A drug formulary is a list of safe drugs used to treat sick people and improve health. The Meridian Health Plan (MHP) Formulary uses the clinical advice of doctors, pharmacists and other medical experts to come up with this drug list.
Click here for the 2014 Meridian Health Plan Medicaid Formulary
Formulary Updates May 2014
Formulary Updates April 2014
What is a Pharmacy Benefits Manager (PBM)?
A PBM is a business that works with insurance companies to fill member prescriptions. MeridianRx is the PBM for Meridian Health Plan. MeridianRx also takes care of drug prior authorization (PA) requests for MHP.
What is Prior Authorization (PA)?
The MHP Formulary is a detailed list of safe drugs. There may be times when your doctor prescribes a drug for you that is not in the formulary. Your doctor can fill out a PA request form, giving facts about your medical history and why you need the drug. Note: We must approve the drug before you can fill the prescription.
What happens if the Prior Authorization (PA) is not approved?
MHP and the MeridianRx Formulary Team may deny a drug request for medical reasons. If your doctor's PA request is not approved, you and your doctor will get a letter explaining why. The letter will also explain the appeal process if you and your doctor disagree with the denial.
What is a quantity limit (QL)?
For some drugs, there are limits to how much you can take safely. This limit is based on research from the drug maker and the FDA. The QL is the amount of drug that can be filled safely each month. If your doctor feels that you need more of a medication, he/she must fill out a PA request.
What is Step Therapy?
Step Therapy means that the doctor will prescribe the best-known drug for your condition first. If this drug does not work, another drug may be tried. You must try the first line drug before your doctor can prescribe another drug for the same reason. Your doctor will fill out a PA request form. Your doctor will explain when the drug was used and why the drug did not work.
I have a question about my medicine. What is the MeridianRx phone number?
You can call MeridianRx toll-free at 866-984-6462.