The Indiana Health Coverage Programs (IHCP) contracts with Optum Rx to be the pharmacy benefits manager for Traditional Medicaid.
Optum Rx is responsible for working in concert with the state to develop the Traditional Medicaid preferred drug list, process drug authorization requests, and ensure the timely and accurate payment of pharmacy claims.
Providers in need of assistance from the Traditional Medicaid pharmacy benefits manager can contact the Optum Rx Clinical and Technical Health Desk at 855‑577‑6317. Additional contact information can be found on the IHCP Quick Reference Guide.
Additional information on pharmacy benefits, including the Traditional Medicaid preferred drug lists and drug prior authorization criteria, can be found on the Pharmacy Services page. For information on Traditional Medicaid pharmacy policies and processes see the IHCP Pharmacy Services provider reference module.
Members enrolled in the Healthy Indiana Plan, Hoosier Care Connect, Hoosier Healthwise or Indiana PathWays for Aging (PathWays) receive pharmacy benefits through their health plan.