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Pharmacy Benefits Expanded for Adult Medicaid Clients


Six prescriptions paid for monthly, plus other medication types that do not count toward limit

For Immediate Release:
January 3, 2022

Media Contacts
Amy Webb, Chief of Communications & Community Engagement

Gavin Lesnick, Deputy Chief of Communications

(LITTLE ROCK, Ark.) — Arkansas Medicaid clients can now get additional prescriptions paid for each month. Previously, Arkansas Medicaid paid for up to three (3) prescriptions for adult clients per month. Clients’ doctors also could request three (3) more prescriptions if needed.

Now, adult Medicaid clients can get up to six (6) prescriptions paid for by Medicaid per month. Also, multiple classes of routine medication will not count toward that limit. That means clients can get these types of prescriptions covered AND get up to six (6) other prescriptions paid for by Medicaid. Clients’ doctors will not be able to ask Medicaid to cover any additional prescriptions.

The medication types that do not count toward each client’s limit are:

•    High blood pressure
•    High cholesterol
•    Bleeding disorders
•    Diabetes
•    Inhalers for breathing disorders
•    Birth control pills
•    Contraceptives
•    Medications used to treat opioid disorder
•    Medications that help you stop smoking

As required by Arkansas Code Annotated 20-77-406 (Act 758), these expanded benefits only apply to adults age 21 and older who are in the fee-for-service Medicaid program. Those under 21 years of age will continue to get an unlimited pharmacy benefit. This does not apply to a client in a PASSE (Provider-led Arkansas Shared Savings Entity) or clients in a Qualified Health Plan through the Medicaid waiver program ARHOME (Arkansas Health and Opportunity for Me).

For more information, clients can call the Arkansas Department of Human Services Pharmacy Department at 501-683-4120 or call the Magellan Help Desk at 1-800-424-7895. 

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