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Tools

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Drug Lookup

Search Kentucky Medicaid PDL and drug coverage status.

Pharmacy Locator

Search for a pharmacy to get directions or other helpful information.

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Managed Care Contact Information

Anthem Blue Cross and Blue Shield Medicaid

(855) 661-2028
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Passport Health Plan by Molina Healthcare

(800) 578-0775
Visit Website

Aetna Better Health® of Kentucky

(855) 300-5528
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Humana Healthy Horizons in Kentucky

(800) 444-9137
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Documents

Manuals, payer specs, newsletters and more!

Forms

Prior authorizations, new prescription, refills,  and claims.

Links

Links to helpful resources.

Commonwealth of Kentucky

The Commonwealth’s Medicaid program that provides health care for 1.2 million Kentucky members.

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Fraud & Abuse

Find more information about reporting fraud and abuse.

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News

Kentucky Newsroom and Media Center.

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Provider Directory

To locate an enrolled Medicaid provider, use the DMS Provider Directory

Upcoming Meetings

June 09, 2021

No upcoming meetings have been scheduled at this time.

View Kentucky Medicaid Pharmacy and Therapeutics (P&T) Advisory Committee Meeting calendar here:

Announcements

June 23, 2021

Draft Kentucky Medicaid MCO PBM Pharmacy Provider Point-of-Sale (POS) Billing Manual

A draft version of the Kentucky Medicaid MCO PBM Pharmacy Provider Point-of-Sale (POS) Billing Manual has been published to Documents. You may also find the document here:

Pharmacy Billing Manual - Draft

A final version of this document will be published in July.

June 15, 2021

Kentucky Medicaid MCO Covered OTC List

The Kentucky Medicaid Single MCO PBM Program has implemented a single, combined Covered OTC List that will apply for all MCOs. You can find that list here: 

OTC List

May 19, 2021

Kentucky Medicaid MCO Single PBM Program Goes Live 7/1/2021

EFFECTIVE 7/1/2021: BIN 023880; PCN KYPROD1; GROUP KYM01

Beginning 7/1/2021 Technical Call Center lines are open at (800) 210-7628 to answer your claim-related and other questions.

Also beginning 7/1/2021 the Clinical Call Center lines are open at (844) 336-2676 for PA requests and inquiries.