Pharmacy

Pharmacy Search

To find a pharmacy near you, use our Online Pharmacy Search tool.

Pharmacy Resources

For a list of drugs covered under your patient’s plan, step therapy and prior authorization criteria, and information about coverage determination requests, view or download a copy of the documents below.

Meridian Preferred Drug List (PDF) Last updated 2/6/2024
- Preferred Drug List Updates
Illinois Formulary Quarterly Summary (PDF) Last updated 7/13/2023

To submit a medication prior authorization, use covermymeds or fax the Medication Prior Authorization Request Form (PDF) to 855-580-1695

Pharmacy Disputes

Disputes for pharmacy claims should be submitted via the Express Scripts® Pharmacist Resource CenterExternal Link.
MAC Appeals InstructionsExternal Link

Meridian utilizes Express Scripts® as its Pharmacy Benefit Manager (PBM). The PBM provides Meridian members and providers with a pharmacy network, pharmacy claims management services, and pharmacy claims adjudication. Member eligibility is determined prior to authorizing any drug benefit.

Meridian offers prescription Provider Support at 855-580-1688. Meridian providers may also speak with a clinical pharmacist regarding any pharmaceutical, medication administration or prescribing issues.

Medicaid members have both prescription and specific over-the-counter medication coverage. All providers must prescribe from within the drug formulary unless a drug prior authorization is obtained. There are also a few specialized medications in the drug formulary identified as requiring a prior authorization.

To prescribe a drug that requires prior authorization and/or a drug is not on the preferred drug list, providers can submit a request using covermymeds or complete a Medication Prior Authorization Request Form (PDF). These forms can be faxed to 855-580-1695. In emergency situations, please phone 855-580-1688.

If prior authorization is not obtained in advance, the member will not be able to fill the prescription at the pharmacy, causing a delay in obtaining needed medication.

For members struggling with opioid addiction, it is important to provide the right treatment at the right time. Go to the CDC Website for resources that may help in identifying the appropriate treatment.

Meridian partners with Affinity Patient Coordination to provide pharmacist-driven care coordination that assists members in managing their medications. Additionally, members who take six or more medications may be able to participate in a pill pack program to get their medications delivered right to their home

Meridian also offers a 90 day supply (three month supply) of maintenance medications at any network pharmacy. These drugs are used to treat long-term conditions or illnesses. A list of maintenance medications can be found by accessing the PDL (PDF). To transfer a current prescription, request a prescription refill, or have your doctor phone a prescription directly to our mail order pharmacy, call Express Scripts® at 833-750-4300 or go to the Express Scripts® website.