Pharmacy benefits


Anthem Blue Cross and Blue Shield will administer pharmacy benefits for members enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect. CarelonRx* is the pharmacy benefits manager. Please refer to the preferred drug list (PDL) when prescribing for these members.

Preferred Drug List and Formulary Search

Statewide Uniform Preferred Drug List

The Statewide Uniform Preferred Drug List (SUPDL), implemented by the Indiana Health Coverage Programs (IHCP), is a list of brand-name and generic drugs available for members under all managed care plans serving Hoosier Healthwise, Healthy Indiana Plan, and Hoosier Care Connect.
 
 
Anthem manages medications and supplies that are not part of the SUPDL.
 

Preferred Drug List

Formulary Search

Specialty Drug List

Benefit exclusions

Benefit exclusions are services not covered under the pharmacy benefit, which include medications:

  • To treat infertility.
  • To treat erectile dysfunction.
  • For cosmetic reasons (Anti-wrinkle, hair removal, hair growth).
  • Not approved by the FDA.
  • That can be bought over the counter (unless specified on formulary or PDL).

To get pharmacy prior authorizations:

You can also request prior authorization by calling:


Hoosier Healthwise

1-866-408-6132

Healthy Indiana Plan

1-844-533-1995

Hoosier Care Connect

1-844-284-1798

Indiana PathWays for Aging

1-833-569-4739

Fax (Retail)

1-844-864-7860

Fax (MI)

1-888-209-7838

To find an in-network pharmacy

Use our Find a Doctor tool .

For inquiries, Chain and Pharmacy Services Administration Organization (PSAO) pharmacies can submit paid claim appeals through their respective chain or PSAO headquarters, which will then submit appropriate data to Caremark.

Independent pharmacies (those that are not affiliated with a PSAO for contracting purposes) can submit paid claim appeals using the Caremark Pharmacy Portal .

Related information

*CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield.

Page Last Updated: 07/12/2024

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