2024 Medical Assistance (Medicaid) list of covered drugs (formulary)
Medical Assistance plans
- Prepaid Medical Assistance Program
- MinnesotaCare
- Minnesota Senior Care Plus
- Connect
This page is a formulary only. See formularies with cost estimates.
Drug search
Formulary documents and 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. |