2024 Medicaid list of covered drugs (formulary)
Medicaid plans
- Prepaid Medical Assistance Program
- MinnesotaCare
- Minnesota Senior Care Plus
- Connect
This page is a formulary only. See formularies with cost estimates.
Drug search
More formulary information
| Documents | Last updated Date |
| Minnesota Health Care Programs List of Covered Drugs (Formulary) (PDF) Minnesota Health Care Programs List of Covered Drugs (Formulary) Arabic (PDF) Minnesota Health Care Programs List of Covered Drugs (Formulary) Hmong (PDF) Minnesota Health Care Programs List of Covered Drugs (Formulary) Russian (PDF) Minnesota Health Care Programs List of Covered Drugs (Formulary) Somali (PDF) Minnesota Health Care Programs List of Covered Drugs (Formulary) Spanish (PDF) Minnesota Health Care Programs List of Covered Drugs (Formulary) Vietnamese (PDF) |
12/1/2024 12/2/2024 12/2/2024 12/2/2024 12/2/2024 12/2/2024 12/2/2024 |
| Prior Authorization Criteria |
8/1/2024 |
| Diabetes Supply List (PDF) | 5/1/2024 |
| Medical Injectable Authorization List (PDF) | 11/13/2024 |
| Non-Preferred Drug Prior Authorization Criteria (PDF) | |
| Medication Therapy Management (MTM) - available at no additional cost to members with chronic health conditions who take multiple medicines. |