Members

Single Pharmacy Benefit Manager (SPBM)

presdrugs
 

Molina Healthcare works with a Single Pharmacy Benefit Manager (SPBM) to help you with your prescription drug needs. The SPBM works with all Medicaid managed care plans to give you quality care and access to pharmacies.

Gainwell is the SPBM that will help you with your prescription drug needs. Call Gainwell Member Services at (800) 884-3222, 24 hours a day, 7 days a week if:

  • You need to ask about a drug.
  • You have trouble getting a prescription filled at the pharmacy. (Please do not pay for the prescription.) Prescriptions are covered through Gainwell's contracted pharmacies within Mississippi.
  • You need an interpreter to communicate with the pharmacy about getting your medication.
  • You have an emergency and need drugs. Gainwell will provide you with up to a 72-hour supply of the drug.

 

Learn more about the SPBM and how it benefits you at the link below:

Medicaid to implement single Pharmacy Benefit Administrator - Mississippi Division of Medicaid (ms.gov)

Unified Preferred Drug List

Gainwell uses The Mississippi Division of Medicaid (DOM)’s universal preferred drug list (PDL) for all MississippiCAN (MSCAN) and Children’s Health Insurance Program (CHIP) members. 

The PDL is a list of prescription drugs that are recommended for doctors to use.

All Coordinated Care Organizations use the same Universal Preferred Drug List to help prescribers and members know which drugs are covered with or without prior approval.

Using one drug list across all managed care plans and Fee-for-Service helps prescribers and members know which drugs are covered with or without prior approval.

For an archive of UPDL changes, visit the Universal Preferred Drug List.