Frequently Asked Questions: DMAP Prescription Coverage
This page provides information about DMAP's policies for fee-for-service pharmacy reimbursement.
If you have questions not answered by this page, refer to DMAP's pharmacy rulebook and supplemental information, which contain the rules and procedures for DMAP claim submissions. For patients enrolled in OHP managed care plans, refer to the reimbursement policies of the individual's plan.
Q: Does DMAP/OHP cover [a particular] drug?
Q: Where can I find the formulary list for OHP managed care plans?
Q: What are the copayment requirements for OHP clients?
Q: What is the Preferred Drug List (PDL)?
Q: Who created the PDL?
Q: Why do we have a PDL?
Q: How do I use the PDL?
Q: Where can I find the Preferred Drug List (PDL)?
Q: How do I get on the PDL?
Q: When is the next Pharmacy & Therapeutics Committee meeting? How can I get notified of future meetings?
Q: How often does DMAP update the Whole Acquisition Cost (WAC) of covered medications?
Q: How does DMAP reimburse pharmacies for drugs?
Q: Who can DMAP reimburse for drugs?
Q: How does DMAP reimburse pharmacies for EPIV services?