Pharmacy Frequently Asked Questions
Take your MeridianComplete Member ID card to the pharmacy. You should also take personal identification, like a driver's license or state issued identification card, with your picture on it.
A List of Covered Drugs (Drug List) is a list of prescription drugs covered by Meridian Complete. The plan chooses the drugs on this list with the help of doctors and pharmacists. The Drug List tells you if there are any rules you need to follow to get your drugs. The Drug List is sometimes called a "formulary." For more information on how to fill your prescriptions, please review your Member Handbook.
There may be times when your doctor orders a drug for you that is not approved in your plan. Your doctor can fill out a PA request form, giving facts about your medical history and why you need the drug. Note: We must approve the drug before you can fill the prescription.
MeridianComplete may deny a drug request for medical reasons. If your doctor's PA request is not approved, you and your doctor will get a letter explaining why. The letter will also explain the appeal process if you and your doctor disagree with the denial.
This drug has a limit on the amount that our plan will cover. If your doctor feels that you need more of a drug, they must fill out a PA request.
Sometimes more than one medication can be used to treat your condition. Step therapy means that one drug must be tried first before another is prescribed. Your healthcare provider or pharmacist can explain which drug must be tried first.
You can call MeridianComplete toll-free at 1-855-323-4578 (TTY:711), Monday - Sunday, 8 a.m. to 8 p.m.