Medicaid Pharmacy Benefits | Healthy Blue Kansas

Getting your prescriptions in Kansas is easy

Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. Remember to show the pharmacy your Healthy Blue member ID card.

Find a pharmacy 

Have questions about your pharmacy benefits?

Call Pharmacy Member Services, 24 hours a day, seven days a week at 833-838-8558 (TTY 711).

Medications straight to your doorstep

With the Community Pharmacy Total Care pharmacy program, you’ll get customized pharmacy care designed to support your health. Community Pharmacy Total Care will connect you with a participating local pharmacy. The pharmacy will package your medications by time and day to help you understand what to take and when. They’ll also schedule hand-delivery. You may even qualify for one-on-one support from the local pharmacy. They’ll create a personalized care plan to help manage your medications and health conditions.

Here’s how it works:

Call to enroll at 844-947-3784 Monday through Friday, 8 a.m. to 4:30 p.m. Central time.
Your prescriptions will be transferred by your participating local pharmacy. They’ll package your medications by time and day and set up fill dates so they’re on the same schedule.
Receive your prescriptions by scheduled hand-delivery. When your prescriptions are ready, the pharmacy will call you to schedule delivery for a day and time that’s most convenient.

Discover more about your drug coverage

Did you know Kansas has a list of preferred and non-preferred drugs chosen for quality and effectiveness? It's called the KDHE Preferred Drug List (PDL).

Most preferred drugs on the PDL do not require preapproval. Non-preferred drugs on the PDL will require preapproval. This means your doctor must get approval from us. Since the PDL can change at any time, be sure to check back here for updates.

KDHE Preferred Drug List (English) 

Some medicines need preapproval, or an okay from us, before they can be filled. For those medicines, your doctor must submit a preapproval request before you can fill your prescription. They can do this by calling Provider Services at 833-838-2595 (TTY 711) or by faxing the request to: 

877-941-9901 Fax for retail requests; or
877-941-9841 Fax for Physician Administered Drug requests.

Preapprovals are necessary for drugs that: 

Have the potential for serious side effects.
Should be prescribed only for specific usage.
Have a high misuse or abuse potential.
May cost more than other preferred drugs.

The preapproval process helps us make sure you’re taking medicines safely and correctly.   

You may also need preapproval when: 

Requesting a higher dosage than recommended.
The drug is part of a step-therapy treatment plan.
Requesting a brand-name drug that already has an FDA-approved generic version.

The Healthy Blue Kansas formulary is a list of all brand-name and generic drugs available in your plan. The formulary will show preferred and non-preferred drugs, preapproval requirements, and drug limitations. Use the formulary to search for drugs by:

Typing the name of the drug in the search box.
Using the A–Z list to search by the first letter of the drug name.
Selecting the therapeutic class of the drug.

If you need a drug that isn’t listed on he Healthy Blue Kansas formulary, you or your representative can request a formulary exception at submitmyexceptionreq@healthyblue.com. 

Search the Healthy Blue Kansas formulary