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Pharmacy

Participant ID Card Update

Dear Participant,

We are writing to let you know that PA Health & Wellness will be switching to Express Scripts for its pharmacy benefit manager in 2024. We are expecting very little changes to your pharmacy benefits with this transition to Express Scripts.

Because of this change, you will receive a new ID Card in the mail in November 2023. Begin using this new card in January 2024. You can continue to use your current 2023 card for the remainder of the year. Please remember to keep your ACCESS cards. 

If you have any questions, please call 1-844-626-6813 (TDD/TTY: 711).

Thank you,

The PA Health & Wellness Pharmacy Team

From PA Health and Wellness

PA Health and Wellness is committed to providing appropriate, high-quality, and cost-effective drug therapy to all PA Health and Wellness participants. PA Health and Wellness’s Pennsylvania prescription insurance covers prescription medications and certain over-the-counter medications with a written order from a PA Health and Wellness provider.

This Pennsylvania prescription drug coverage program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.

Preferred Drug List (PDL) 

To download a listing of covered drugs or search the PDL by drug, visit the Pennsylvania Department of Human Services web portal and select:

Pennsylvania PDL

PHW Supplemental Drug List

Download the PHW Supplemental Drug List (PDF)

Pharmacy Policies

To access, view or download an active Pharmacy Policy for a covered drug on the Pennsylvania Medical Assistance Program's Statewide Preferred Drug List (PDF) or the PHW Supplemental Drug List, visit:

PA Health and Wellness Policies

PHW Specialty Medication List

Download the PHW Specialty Medication List (PDF)

Express Scripts Pharmacy Network (For use in 2024)

To view the list of Express Scripts Network Pharmacies contracted with PA Health & Wellness in 2024, download the Contracted Express Scripts Network Pharmacies (PDF)

Filling Prescriptions for Extended Day Supply

PA Health and Wellness members may fill prescriptions for certain maintenance medications for up to a 90 day supply at participating pharmacies. To see which medications are eligible to be filled for extended day supply and which pharmacies participate in the extended day supply program, click the links below or contact a customer service representative at 1-844-626-6813 (TTY 711):

Pharmacy Reimbursement Forms