NYRx Information for Medicaid Members

What You Need to Know About Getting Your Prescription Drugs through Medicaid

Your pharmacy benefit is the part of your Medicaid health insurance that helps you pay for your prescription drugs and supplies. Before April 1, 2023, Medicaid members enrolled in a Medicaid Managed Care (MC) plan access their pharmacy benefit through their health plan. Medicaid members enrolled in Medicaid Fee for Service (FFS) access their pharmacy benefit through Medicaid Fee for Service. The Medicaid Fee for Service pharmacy benefit has been renamed NYRx, the Medicaid Pharmacy Program.

Beginning April 1, 2023, all Mainstream MC Medicaid members will get their drugs through NYRx, the Medicaid Pharmacy Program. This applies to consumers enrolled in MC plans, Health and Recovery Plans (HARPs) and HIV-Special Needs Plans (HIV-SNPs). Managed Long-Term Care plans (e.g., PACE, MAP, MLTC) and the Essential Plan are not included.

For all Medicaid members affected by this change, our goal is to make this transition as seamless as possible by providing you the information and resources you may need in preparation for the move from your MC to NYRx.

• Understanding the Move from Managed Care to FFS: History and Objectives
• Frequently Asked Questions (FAQ)
• Covered Drugs, Preferred Drugs and Covered Supplies in Medicaid FFS
• Pharmacies that take Medicaid FFS
• Member Notice of Change (PDF)
• Member Fact Sheet: What You Need to Know (PDF)
• Dual Eligible Member Notice of Change - (PDF)
• If you need help or have questions, please contact us:

By email: NYRx@health.ny.gov.	By phone: The Medicaid Helpline can help you in your preferred language: 1-855-648-1909. TTY 1-800-662-1220 Open Monday - Friday, 8 am - 8pm and Saturday, 9am - 1 pm	If you are interested in receiving MRT email alerts, visit the MRT LISTSERV web page to subscribe.