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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 |