Nebraska Medicaid Preferred Drug List

The medications on the Nebraska Medicaid Preferred Drug List (PDL) are covered by Nebraska Total Care. Non preferred drugs on this list may be covered when certain requirements are met. Other limitations for specific drugs may exist and are explained in the Nebraska Medicaid Claims Limitations (PDF).

Nebraska Total Care is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Nebraska Total Care members. Nebraska Total Care covers prescription medications and certain over-the-counter medications with a written order from a Nebraska Total Care provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services may be covered as well. Current maximum allowable cost (MAC) pricing information for all products can be found on the ESI Pharmacist Resource Center (effective January 1, 2024).

Electronic Prior Authorization Submissions

Submit your prior authorization (PA) requests electronically through our preferred solution CoverMyMeds. Electronic prior authorization (ePA) automates the PA process making it a quick and simple way to complete PA requests. The ePA process is HIPAA compliant and enables faster determinations. You may also use this link to track ePA requests.

Contact Us

ESI Express Scripts Helpline
Phone: 833-750-4471
(effective January 1, 2024)

Pharmacy Services
Prior Auth Phone: 844-330-7852
Prior Auth Fax: 833-404-2254

Nebraska Total Care
Phone: 1-844-385-2192 (TTY 711)