Pharmacy Services

The plan covers drugs listed on our Preferred Drug List (PDL). Some drugs will require approval through a Coverage Determination Request (CDR) filled out by your doctor. (This applies to drugs that require prior authorization and those drugs not listed on the PDL.) The list will also have drugs that may have limits such as prior authorization, quantity limits, step therapy, age limits or gender limits.

Search for a Drug

Printed Preferred Drug Lists:

• 'Ohana CCS Preferred Drug List (PDF)
• 'Ohana CCS Machine Readable File
• 'Ohana CCS Dual Eligible Preferred Drug List - Multi (PDF)

Drug Evaluation Request Forms:

• Request Medicaid Prescription Drug Coverage
• Request Appeal for Medicaid Drug Coverage

Always show your 'Ohana ID Card at the pharmacy.

• Medicaid-only members should not have to pay co-pays for drugs on 'Ohana's Preferred Drug List (PDL). But there may be times when you have to pay for covered drugs.
• This can happen if you forget to show your 'Ohana ID card at the pharmacy.
• If you do pay out of pocket for covered drugs, you can ask for a refund. Just fill out a Direct Member Reimbursement Request Form and send it to 'Ohana.