Link to MassHealth Pharmacy Program COVID-19 information. Please note, guidance will be updated as needed and as additional information is available.

Link to the list of drugs preferred by MassHealth based on supplemental rebate agreements between MassHealth and drug manufacturers. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing a non-preferred drug within a therapeutic class.

Link to the list of therapeutic classes for which preferred and non-preferred pharmacy products have been designated and the obligations of MassHealth Accountable Care Partnership Plans and Managed Care Organizations with respect to those classes.

Link to the list of brand name drugs that MassHealth prefers over their generic equivalents because the net cost of the brand name drug adjusted for rebates is lower than the net cost of the generic equivalent. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing the non-preferred drug generic equivalent.

Link to a list of the drugs that are the only nonlegend drugs, with the exception of insulins, that are covered by MassHealth without prior authorization.

Link to a list of non-drug products that MassHealth pays for through the Pharmacy Online Processing System (POPS).

Link to the list of the professional services that MassHealth pays for through the Pharmacy Online Processing System (POPS).

Link to the current list of “APAD Carve-Out Drugs” and “APEC Carve-Out Drugs” for which a Hospital must obtain prior authorization (PA) from MassHealth. Please note that these treatments will be subject to monitoring. Other requirements also apply.

Please note that this document does not represent the complete MassHealth Drug List.