Pharmacy

Care Source Rx Innovations Logo RGBCareSource RxInnovations™ has partnered with Express Scripts® to help you manage your prescriptions and save money.

Prescription Drug Benefits

With CareSource MyCare Ohio you receive more of the medications you need with no copays for covered prescriptions and some non-part D and over-the-counter (OTC) drugs as specified by the Ohio Department of Medicaid.

You have the option to fill most drugs up to a 102-day supply. You can get a 102-day supply from your pharmacy or through mail order.

Have questions about your medication, ask a pharmacist!

Talk to a CareSource RxInnovations pharmacist to review your medication and get your questions answered. Depending on your medications and conditions, our pharmacists may even reach out to you to check in on your medications. As a CareSource member, you get this benefit for free. No appointment needed! Call 1-833-230-2073 to speak with a pharmacist today! We are open 9 a.m. to 5:30 p.m. Monday through Friday.

Comprehensive Drug Formulary

CareSource MyCare Ohio uses a Comprehensive Formulary.  The list shows the drugs we want your primary care provider (PCP) to order for you. Some drugs require prior authorization or are not covered by Medicare. Some drugs may also have quantity limits, and some drugs may require step therapy.

The comprehensive formulary is the entire list of Part D drugs covered by your Part D plan:

 2025

 2024

Throughout the year, changes may occur to drugs on our formulary. Check this list to view the updates.

The Over-the-Counter (OTC) Items and Non-Part D Drug List outlines additional coverage for certain OTC items and non-Part D drugs included in your plan offering. The below is a detailed list of products payable at your local, participating pharmacy. These products are listed in your MyCare Comprehensive Formulary with the abbreviation “ADD”. ADD stands for Additional Demonstration Drug list. ADD indicates the additional OTC items and non-Part D drugs are covered by the Medicaid benefits of your plan.

Prior Authorization Criteria – For certain drugs, your doctor will need to contact us before you can fill your prescription.

Step Therapy Criteria – For certain drugs, we require you to first try another drug to treat your medical condition before we will cover the drug your doctor initially prescribed.

Generic vs. Brand-Name Drugs

It is the policy of CareSource to limit the use of a brand-name drug when a generic version is available. Generally, a generic drug works the same as a brand-name drug and usually costs less. If there is a generic version of a brand-name drug, our network pharmacies will give you the generic version. Please see your Member Handbook on the Plan Documents page for exceptions.

Drug Safety Recalls

Sometimes, the federal government or drug manufacturer issues drug recalls. To find out if a drug you take is being recalled, please check the listings on the Food and Drug Administration (FDA) website.

Quality Assurance

CareSource understands the accuracy of the formulary is important. We regularly check to make sure the online formulary tool is the approved version. Generally, if you are taking a drug on our formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the coverage year. There are times when this may change like when a new, less expensive generic drug becomes available or when new adverse information about the safety or effectiveness of a drug becomes available. If these changes occur, no prior notification will be provided before the changes are made. However, we will give 30 days notice to you when:

  • Taking a drug off the list.
  • Changing a prior authorization.
  • Changing a quantity limit.
  • Changing a cost tier.

You can ask us about drug safety at any time. You can access an online formulary or print one from our website. You may also ask us to mail you a copy. Just call Member Services at 1-855-475-3163 (TTY: 1-833-711-4711 or 711), 8 a.m. to 8 p.m., Monday through Friday.