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General Information

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Table

General Information

State / Territory Open Formulary Excluded Drugs (if open formulary) ADAP Supports Two Formularies: Full-Pay Medication Program and ADAP-Funded Insurance Program: One for Full-Pay Medication Program Additional Drugs and Services are Available to Clients with Clinical Provider's Approval
Alabama No No No
Alaska No No No
Arizona No Yes Yes
Arkansas No No No
California No No No
Colorado No No No
Connecticut No No No
Delaware No No No
District of Columbia No No Yes
Florida No No No
Georgia No No No
Guam No No No
Hawaii No No No
Idaho No No Yes
Illinois Yes Botulinum toxin; Compounded medications for infusion; Gonadotropin; Hyaluronic acid derivatices, TNF-alpha blockers; Monoclonal antiboidies; Recombinant human growth hormone / Synthetic growth hormone; Antirheumatic antibetabolities; Cosmetic medications; Durable medical equipment; Erectile dysfunciton medications; Female sexual dysfunciton medications; Fertility drugs, Herbal medications; Injectable muscle relaxants; Nutrition supplements; Vaccines / immunizing biologicals; Weight loss medications; C-II, C-III, CIV, CV controlled substances No No
Indiana No Yes No
Iowa Yes Abortifacients; Acne medications; Anti-rheumatic injectables; Blood Sera; Botox; Compound medications (Prior Authorization required); Cosmetic medications; Durable Medical Equipment; Erectile Dysfunction medications; Fertility medications; Hair Removal / Growth medications; Human Growth Hormone; Hyaluronic Acid derivatives; Immune Globulin intravenous; Infusions; Injectable muscle relaxants; Provider administered drugs; Medical Cannabidiol; Schedule 2 controlled substances (Percocet, Adderall, hydrocodone, methadone, etc. ); Cough suppressants that contain controlled substances (hydrocodone, codeine, etc.) No Yes
Kansas No No Yes
Kentucky No No No
Louisiana No Yes No
Maine No No No
Maryland Yes Infusion drugs (medical benefit); medical supplies; IVIG Diagnostic products; Antiviral MAB; Cardiovascular diagnostics; Venosclerosing agents; Lung surfactants; PDE-5 inhibitors; Prostaglandin agonists; Opioids analgesics; Opioid containing drug products; Water Tham solution; Tromethamine IV dextrose-water solutions; Nucleic acid / nucleotide supplements; Diluent solutions; PKU formulations; Bioflavonoids Agents for stomatological use; Saliva substitute agents; Fat absorption decreasing agents; Implantable contraceptives; Local anesthetics; Benzodiazepine type injectable general anesthetics; Inhalant general anesthetics; Barbiturates; Systemic use alcohol; Ipecac syrup; Smoking deterrents; Belladonna alkaloids; Anti-obesity-anorexic agents; Topical / subcutaneous mucous enzymes; Emollients; Wound healing agents; OTC irritants; Plasma proteins; Antihemophilic factors; Factor IX preparations; IV fat emulsions; Coagulants; Sclerostin inhibitors; Vascular endothelial growth factor inhibitors; OTC eye vasoconstrictors; Osmotic diuretics; Neuromuscular blocking agents; Homeopathic drugs; Herbal drugs; Solvents; Bulk chemicals; Vehicles; Suspending agents; Surfactants; Antineoplastic vinca alkaloids; Radioactive therapeutic agents; Antineoplastic antibody drug complexes; Antineoplastic EGF receptor blocker; MAB Antineoplastic car-t cell immunotherapy agents; Kinase / aromatase inhibitor combo; Topoisomerase inhibitors; Antineoplastic epothilones and analogs; Antineoplastic anti-CD38 MAB; Antineoplastic anti-programmed death-1 MAB; Antineoplastic anti-SLAMF7 MAB; Condoms; IUDs No Yes
Massachusetts Yes finasteride (approved for prostate cancer only); minoxidil; cosmetic medications; erectile dysfunction medications; fertility drugs; herbal medications No No
Michigan No No Yes
Minnesota Yes Scheduled medications and any other medications restricted by state Medicaid. No No
Mississippi No No No
Missouri No No No
Montana No No No
Nebraska Yes several categories requiring a PA before payment No Yes
Nevada No No No
New Hampshire Yes IV immune globulin No No
New Jersey Yes Medicare Part-D excluded drugs such as Vitamins, Antitussives and Expectorants; cosmetic medications. No No
New Mexico No Yes Yes
New York No No No
North Carolina No Yes No
North Dakota Yes Abortifacients; Acne medications; All controlled substances; Antipsychotics; Antirheumatic injectables; Blood; Botulinum toxin; Chemotherapeutic agents; Compounded medications; Cosmetic medications; Cough suppressants; Durable medical equipment; Erectile dysfunction treatments; Fertility medications; Gabapentinoids; Hair removal / growth medications; Hepatitis C treatments (assistance with copays / deductibles only); Herbal medications; Human growth hormone; Hyaluronic acid derivatives; Immunoglobulin-intravenous; Infusions; Muscle relaxants Yes Yes
Ohio Yes Abortifacients; Alzheimers Medication; Acne Medications; Chemotherapeutic Agents (EXCEPT imiquimod cream); Controlled Substances(Class Schedules II, III, IV, and V; EXCEPT pregabalin); topical testosterone; Cosmetic Medications / Hair Removal / Growth Medications; Durable Medical Equipment; EGRIFTA SV; Fertility Medication; Finasteride; Hepatitis C Treatments; Herbal Medications; Human Growth Hormone; Hyaluronic Acid Derivatives; Injectable Muscle Relaxants; Sexual Dysfunction Medications No No
Oklahoma No No No
Oregon Yes Anorexia, weight loss, weight gain medications; Fertility medications; Erectile dysfunction medications; Hair growth or cosmetic medications; Prescription vitamins and minerals; Non-prescription drugs (OTCs); Nutritional / Dietary Supplements (including herbal supplements); Durable Medical Equipment Yes Yes
Pennsylvania No No No
Puerto Rico No No No
Rhode Island No No No
South Carolina No Yes No
South Dakota No No Yes
Tennessee No Yes Yes
Texas No Yes No
Utah No Yes Yes
Vermont No No No
Virginia No Yes No
Washington Yes Erectile dysfunction medications Yes No
West Virginia No No No
Wisconsin No No No
Wyoming Yes Hemophilia medications; Botulinum toxin; Gonadotropin; Finasteride (except for prostate disorders); Hyaluronic acid derivatives; Immune globulin intravenous (IGIV); Injectable muscle relaxants; Antirheumatic injectables; Monoclonal antibodies; Nutritional supplements; Propoxyphene; Recombinant human growth hormone (HGH); Synthetic growth hormone; Egrifta; Durable medical equipment; Cosmetic medications; Erectile dysfunction pharmaceuticals; Female sexual dysfunction pharmaceuticals; Fertility drugs; Herbal medications; Nicotine cessation products No No