What’s covered
Most of your prescriptions are paid for through your Medicaid drug plan, but not all of them are. CareOregon has a list called a “formulary” that shows which medicines are covered. When your provider prescribes a medicine, ask if it is on CareOregon’s formulary.
Please note: Many mental health prescriptions are paid for by the state, not CareOregon. These drugs may have a small cost (copayment).
This formulary was last updated March 2026.
Call Customer Service to get a paper copy of the formulary. It’s free, and you’ll get it within five business days.
If you need a machine-readable file, download the CareOregon OHP Formulary (JSON) format.
Prior authorization for prescription drugs
Some medications have prior authorization criteria. To see which ones do, view the CareOregon OHP Prior Authorization Use Criteria (updated February 2026).
Not finding your medication?
If you need a drug right away that’s not on our formulary, call Customer Service. You, your provider or your pharmacist can ask for an emergency short supply (up to 72 hours).
To fill a prescription, go to any pharmacy in our network. There are lots to choose from, including big pharmacy chains and small local stores. See the “Find a pharmacy” section below for more information.
Refills
- Most prescriptions are limited to 31 days or less.
- You can get a refill 23 days after you fill a prescription.
- You can get a 90-day supply of medications for long-term health conditions.
Reimbursement forms
If you want to get paid back (reimbursed) for buying a COVID test or a medication, you will need to fill out a form.
Member COVID-19 At Home Test Reimbursement Form
Use this form to ask us to pay you back for FDA-authorized COVID-19 test kits you bought at a retail store, pharmacy or online retailer. Reimbursement requests take up to 4-6 weeks to process.
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Direct Member Reimbursement Form
Use this form to ask us to pay you back for pharmacy and prescription purchases.
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Mail-order pharmacies
You can get your medicine sent to your home with our mail-order pharmacy. Download and fill out the order form below.
Optum New Prescription Mail-In Order Form
Have your drugs delivered directly to your door by filling out this order form with Optum Mail Order Pharmacy.
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