The management of outpatient prescription drugs is an integral part of the medical management program to improve the health and well-being of our members. Prescriber and member involvement is critical to the success of the pharmacy program.
To help your patients get the most out of their pharmacy benefit please be cognizant of the following guidelines when prescribing:
Preferred Drug List (Medicaid)
Preferred Drug List (Dual-Eligible Members)
Abbreviated Preferred Drug List
Pharmacy Forms
- Abbott Request Fax Order Form
- Accu-Chek Meter Form
- Coverage Determination Request Form (Medicare)
- Drug Evaluation Review Form (Medicaid)
- Injectable-Infusion Form (Medicaid)
- Injectable-Infusion Form (Medicare)
- Synagis Form
The 'Ohana Health Plan Pharmacy Department telephone number is 1-888-505-1198 for Medicaid or 1-866-653-0976 for Medicare. For detailed information about pharmacy services, refer to the Pharmacy section of the 'Ohana Provider Manual.



