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Preferred Drug List
‘Ohana Health Plan covers medically necessary drugs that are required by Medicaid. It is also important to know we use a Preferred Drug List (PDL). These are the drugs that we prefer that your doctor prescribe. Most PDL drugs are covered without a Drug Evaluation Review (DER). Some PDL drugs require a DER and these are noted with a “PA” (prior authorization). There are also some drugs on the PDL that require step therapy or the use of other drugs before they will be approved. They are noted on the PDL with a “ST” (step therapy).
 
The PDL will also have drugs that may have limits due to your age or the quantity prescribed. These are noted on the PDL with an "AL" (age limit) and "QL" (quantity limit).
 
Your doctor will need to submit a DER Request Form for the following:
  • Drugs not listed on the PDL
  • Drugs listed on the PDL with a prior authorization
  • Most self-injectable and infusion drugs
  • Brand drugs when generic drugs are available
  • Drugs that exceed the Food and Drug Administration (FDA) daily or monthly quantity limits
  • Drugs with a step therapy

‘Ohana will respond to routine requests within 72 hours. Requests that are needed quickly will be responded to within 24 hours.

 
 

The H1N1 Flu & You

 

2009 H1N1 flu, also known as swine flu, is a new type of influenza. It’s caused by a virus that is spreading to people around the world.

 

Is 2009 H1N1 flu the same as the seasonal flu? No. They are very different. As a result of this, many people will not be protected from 2009 H1N1 flu. This is true even if they have had a seasonal flu vaccine (flu shot). The seasonal flu shot does not protect against 2009 H1N1 flu.

 

Experts think that this flu season will be worse than others because of the 2009 H1N1 flu. The Centers for Disease Control and Prevention (CDC) is getting ready for the flu season to start early this year. The CDC also thinks both the 2009 H1N1 flu and seasonal flu will result in more:

  • Illnesses
  • Hospital stays
  • Deaths

One way to stay safe is to stay informed.The FLU.GOV Web site will help keep you updated on this year’s flu season and 2009 H1N1 flu. Check it often.

 

Have questions?

  • Talk with your PCP. His/her name and phone number are on your member ID card.
  • Call Personal Health Advisor. It’s 'Ohana's 24-hour nurse helpline. The toll-free number is 1-888-846-4262 (TTY/TDD: 1-877-247-6272).

Stay informed. Stay healthy.

 


Last modified: 08/04/2008
 
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