Florida Medicaid Formulary – How Changes Can
Affect You


The Florida Medicaid Formulary is an important resource for those who are getting Medicaid benefits in Florida. Medicaid generally pays for numerous types of drugs and prescription medications that patients need. One major focus of our practice is on Elder Law and obtaining Florida Medicaid benefits or Veterans Benefits for seniors needing assisted living or nursing home care.

Formulary issues are something that needs to be monitored ongoing if a high quality of health care for the elderly is going to be realized. Rarely, if ever, do formulary issues lead to situations where you would need to consult an attorney since those are issues for medical personnel.

Those getting Medicaid benefits in Florida are people with limited assets and incomes, who would not be able to afford their own health insurance coverage if they didn’t qualify for this program. Even though the state government and the federal government work together regarding the issues of Florida Medicaid health insurance, the state can enforce its own rules and policies.

Each state has their own version of Medicaid, although each usually provides the same attention to their recipients; but, there are slight differences since each state can impose its own restrictions and requirements.

For this reason, the state can make changes to the Florida Medicaid Formulary even if other states do not, and corporations and pharmacies can follow suit as long as the changes are legal under the Medicaid Formularies.

For example, in the year 2008 the Florida Healthy Kids Corporation pharmacy benefits were changed to where the drugs that were not included on the Florida Medicaid Formulary were also excluded from the Florida Healthy Kids Corporation approved drug list. Generic drugs were then supplemented for the more expensive brand name prescription pills.

Some of the most well-known brand name drugs that are now being denied under Florida Medicaid health insurance plans include:

  • Allegra and Allegra D
  • Benzaclin
  • Claravis
  • Claritin and Claritin D
  • Doryx
  • Lexapro
  • Olux and olux E
  • Protopic
  • Provigil
  • Prozak Weekly
  • Solodyn
  • Triaz Cleanser
  • Zytrec and Zytrec D
  • Zyvox

Current drugs that are still listed on the Florida Medicaid Formulary include:

  • Spiriva
  • Norpace CR
  • Hydrazide
  • Clonidine
  • Fosrenol
  • Ferrous Sulfate
  • Potassium Iodide
  • Januvia
  • And hundreds of others

Because of these changes, it is important for anyone who is getting Medicaid benefits in Florida to keep themselves up to date on the changes that are made to the Florida Medicaid Formulary. Consult with your medical professionals about changes in the formulary that may end up affecting your prescriptions and your health.

We can help you increase your chances of getting Medicaid benefits in Florida. To learn more, please visit our Medicaid Planning Practice Area.

Please see our Free Article Index for more information on Florida Medicaid health insurance.