Welcome to the NY Medicaid Pharmacy Program (NYRx)

Information about Medicaid´s Prescription Drug Benefit and Changes Coming April 2023

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Beginning April 1, 2023, all Medicaid consumers enrolled in Mainstream Managed Care will receive their prescription drugs through the Medicaid Fee-For-Service (FFS) Pharmacy Program. The FFS Program allows New York State to pay pharmacies directly for the drugs and supplies of Medicaid consumers.

Prior to April 1, 2023, Mainstream Medicaid consumers accessed their pharmacy benefits through a health plan, rather than FFS. This includes anyone in Managed Care (MC) plans, Health and Recovery Plans (HARPs) and HIV-Special Needs Plans (HIV-SNPs). In this case, the state reimburses the health plan rather than the pharmacy.

Moving all Medicaid consumers under the FFS Pharmacy Program allows for a single, uniform list of covered drugs and standardized, consistent rules and regulations. Thus, New York State is able to offer an improved, simplified process for Medicaid consumers to get the medicines and supplies they need. Medicaid consumers have comprehensive drug coverage and equitable access to an extensive network of over 5,000 pharmacy providers.

This transition does not apply to Managed Long Term Care plans (e.g., PACE, MAP, MLTC) or the Essential Plan.

We are committed to providing effective communication in preparation of this change to all Medicaid consumers, pharmacies and providers.

Please see Navigation Bar to the left for more information, FAQs, guidance and resources.

Contact Information

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By email: NYRx@health.ny.gov. By phone:
The Medicaid Helpline can help you in your preferred language: 1-800-541-2831
Open Monday - Friday, 8 am - 8pm and Saturday, 9am - 1 pm
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