What type of drug benefit does Indiana Medicaid provide for full benefit dual eligibles?
Indiana Medicaid provides coverage for Medicare Part D-excluded drugs that are a covered Indiana Health Coverage Programs (IHCP) benefit for people with Medicare and IHCP benefits. This includes, but is not limited to, barbiturates, benzodiazepines, and over-the-counter (OTC) drugs that are on the Indiana Medicaid Over-the-Counter Drug Formulary. For Medicare Part D-excluded prescription drugs that are in classes subject to the Preferred Drug List (PDL), all existing PDL limits and requirements are applicable. Medicare prescription drug plans (PDPs) may choose to cover Medicare Part D-excluded drugs; therefore, pharmacy providers should attempt to bill Medicare prior to submitting claims to the IHCP. For a comprehensive list of drugs covered by IHCP for dual eligible members, see the Medicare D documents.
