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Medicaid Pharmacy Benefits

Do not wait until you are out of a medication to request a refill. Call your doctor or pharmacy a few days before you run out.

Heritage Health - Nebraska Total Care 

Nebraska Total Care provides a wide variety of drugs and pharmacy benefits to members. Below you can find more information about pharmacy benefits offered by Nebraska Total Care, including information about which drugs are covered, how to get medications, and more.

90-Day Maintenance Drugs

Nebraska Total Care members are able to get up to a 90-day prescription fill on maintenance medications. Maintenance medications are used to treat chronic, long-term conditions or illnesses. Nebraska Total Care has a list of 90-Day Maintenance Drugs (Excel).

Copays

Many Medicaid members never have a copay. These members are: 

  • Eighteen years old or younger
  • Pregnant, and for 60 days after the pregnancy ends
  • In an inpatient hospital
  • In a long term care facility
  • In a facility where they have to spend most of their income for medical cost
  • Living in a residential facility, adult family home, or center for the developmentally disabled
  • Native Americans getting services from an Indian Health Center
  • Native Americans getting services referred by an Indian Health Center
  • Receiving waiver services under a 1915(c) waiver
  • Get help from the State Disability Program

You can see the Preferred Drug List (PDL) on this page or we can send it to you. Medications for family planning (birth control) never have a copay. There are some Medicaid members who have a copay for some brand name prescriptions. If you are eligible for a copay it will be $3. 

Update May 11, 2020: Due to COVID-19 we have made a change. At this time, there are no copays for any covered meds.