Formulary
Prescription drugs covered by Medi-Cal Rx
Prescription drugs given by a pharmacy are covered by Medi-Cal Rx, a Medi-Cal FFS program. Some drugs given by a provider in an office or clinic may be covered by PHC California. Your provider can prescribe you drugs that are on the Medi-Cal Rx Contract Drugs List.
Sometimes, a drug is needed and is not on the Contract Drug List. These drugs will need to be approved before they can be filled at the pharmacy. Medi-Cal Rx will review and decide these requests within 24 hours.
- A pharmacist at your outpatient pharmacy or hospital emergency room may give you a 72-hour emergency supply if they think you need it. Medi-Cal Rx will pay for the emergency medication supply given by an outpatient pharmacy.
- Medi-Cal Rx may say no to a non-emergency request. If they say no, they will send you a letter to tell you why. They will tell you what your choices are.
To find out if a drug is on the Contract Drug List or to get a copy of the Contract Drug List, call Medi-Cal Rx at 1-800-977-2273 (TTY 1-800-977-2273 and press 5 or 711), or go to Contract Drug List web page. You can also visit the Medi-Cal Rx website (https://medi-calrx.dhcs.ca.gov).
DHCS MMDDYY PHC FR Form 1.1