This is mainly for my own reference

Other medicaid parents may find it helpful, but this is mainly for my own benefit.  I posted it a while ago on one of my support groups, but am in need of utilizing the information again, so thought I'd post it here so I can find it more easily.

Okay, so you know the problems we've all been having (or at least I have) since January with medications and pre-authorizations and co-pays, etc...I think I figured some things out today. (As a side note I have Medicaid Healthy U I'm not sure if that matters) Some medications are paid for (approved) by "State Medicaid" others by "Ventegra". The State Medicaid approves ones that are more controlled substances (mostly). You can call State Medicaid and go through your med list 1 by one and ask them if they approve that particular med or if ventegra does. The number for State medicaid is 1-800-662-9651 or 801-538-6155 and the number for Ventegra is 1-877-895-7159. Then once you know who is paying for what you can contact them to see which meds require a preauthorization. To see which meds State medicaid requires a pre-auth for follow these instructions, or you can ask the person you talk to on the phone...The website for State Medicaid is http://health.utah.gov/medicaid/ on the right hand side under "Health Care" click on "Pharmacy Program" then on the left hover over "For physicians and Pharmacies". A pop-up will appear, click on "Preferred Drug List". Then at the bottom click on the PDF "Utah Medicaid PDL". The Preferred Drug List (PDL) DO NOT require a preauth. To find out on Ventegra which ones require a pre-auth you have to call them and go through the meds, they do not have it listed online.