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Pharmacy

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.

Nebraska Total Care covers certain prescriptions and over-the-counter drugs when prescribed by a provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage, or maximum quantities. 

You can read more detailed information about the pharmacy program on the Medicaid Formulary, effective September 1, 2018 (PDF).

Nebraska Total Care can cover these types of medication:

You can have your prescriptions filled at any Nebraska Total Care network pharmacy. Show the pharmacy:

  • your prescription
  • your Nebraska Medicaid ID card
  • you Nebraska Total Care ID card 

If you need help finding a pharmacy you can use the Find A Provider tab. You can also call us at 1-844-385-2192 (TTY: 1-844-307-0342, or Relay 711). 

Nebraska Total Care has a list of Specialty Pharmacies (PDF).

Vaccine preventable diseases have not gone away. Vaccines will help keep you healthy.  

How it works: 

  1. Locate a pharmacy. You can use the Find a Provider page or call Member Services.
  2. Call the pharmacy you choose and ask if they have the vaccine you need.
  3. Show your Nebraska Medicaid ID card and Nebraska Total Care ID card. 
  4. Get your vaccination.

No appointment, no copays, no hassle. 

Covered vaccines include: 

  • Injectable Seasonal Influenza Vaccine (Trivalent and Quadrivalent)
  • Intradermal Influenza Vaccine (Short Needle)
  • Injectable Seasonal Influenza - Vaccine High-Dose (Fluzone)
  • Zoster (Zostavax) 
  • Pneumonia
  • Meningococcal

For more information call Member Services at 1-844-385-2192 (TTY: 1-844-307-0342 or Relay 711). 

Search Krames on Demand to get answers to your drug questions.

Copays

There are no co-pays on drugs with Nebraska Total Care. We fully cover all of your medically necessary drugs.

Please note: Beginning January 1, 2019 some members will have copays for some drugs. 

Many 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 alternative care
    • a residential facility
    • an adult family home
    • a center for the developmentally disabled
  • Indians getting services from an Indian Health Center
  • Indians getting services referred by an Indian Health Center
  • Receiving waver services under a 1915(c) waver
    • Community-Based Waiver for Adults with Mental Retardation or Related Conditions
    • Home and Community-Based Waiver for Children with Mental Retardation and Their Families
    • Home and Community-Based Waiver for Aged Persons or Adults or Children with Disabilities
    • Early Intervention Waiver
  • Get help from the State Disability Program

The copay is only for brand name drugs

There is never a copay for medication for family planning (birth control). 

There is never a copay that are on the Preferred Drug List. The Preferred Drug List is posted on this page. 

If you are eligible for a copay it will be $3.