Missouri Medicaid members receive pharmacy benefits through the State’s MO HealthNet Fee-for-Service Pharmacy program. The pharmacy benefit is not administered by the Managed Care Plan.
The pharmacy services managed through the State’s MO HealthNet Fee-for-Service Pharmacy program includes all pharmacy services administered on an outpatient basis, including but not limited to:
For pharmacy services provided in a home health setting, the State’s MO HealthNet Fee-for-Service Pharmacy program will cover the pharmacy service when billed on a pharmacy claim form including all of the appropriate information such as, but not limited to, the National Drug Code (NDC), quantity, and dosage form.
The Managed Care Plan will be responsible for:
Check for frequently updated MO HealthNet Fee-for-Service Pharmacy Program information at http://dss.mo.gov/mhd/cs/pharmacy/pages/frequpdat.htm
Contact the State’s Missouri HealthNet Pharmacy Help Desk at 573-751-6963 for questions on pharmacy claims .
Please review the Opioid Programs and Resources - Community Plan (Medicaid) section.