How Your Montana Healthcare Prescription Drug Program Benefit Works

Even with a prescription from your doctor, not all drugs are covered.

You must use a pharmacy that is a Montana Healthcare Programs Provider

Montana Healthcare Prescription Drug Program covers most prescription drugs. Certain drugs will need a prior authorization (PA). Covered over-the-counter drugs require a written prescription from your healthcare provider.

Check with your Pharmacist or Healthcare Provider to make sure your drug is covered or if it needs a prior authorization

Examples of Covered Drugs

Antacids - Aspirin - Contraceptive supplies and devices - Head Lice Treatment - Non-sedating antihistamines - Self injectable drugs (including insulin) - Drugs to help you quit smoking
Examples of Non-Covered Drugs

Drugs that do not have FDA approval - Experimental or investigational drugs - Drugs to help you get pregnant - Drugs used for weight loss -Cosmetic or hair-growth drugs - Drugs used to treat erectile problems - Drugs not on the OTC Drug Formulary

For most medications, only a 34-day supply can be filled. For some products, a 90-day supply may be authorized; please consult with your pharmacist to confirm if your medication can be filled for a 90-day supply.

Some prescriptions require prior authorization, check with your doctor.

It's your responsibility to...

  • Always show your Member ID card with your prescription to the pharmacy. Your ID card will let pharmacies know that Montana Healthcare Programs pays for your medicines.
  • Do not wait until you are out of a drug to request a refill. Contact your doctor or pharmacy a few days prior to being out of your drug.
  • Don't forget to get Prior Authorization