Pharmacy

Western Sky Community Care covers prescription medications. Western Sky Community Care also covers certain over-the-counter medications with a written order from a Western Sky Community Care provider. The pharmacy program does not cover all medications. Some require prior authorization. Some have limitations based on age or the amount of medicine prescribed.

What Pharmacy Benefits are covered?

Western Sky Community Care covers certain prescription drugs and over-the-counter drugs when prescribed by a Western Sky Community Care provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage or maximum quantities.

Which Drugs are covered?

The Preferred Drug List (PDL) is the list of drugs covered by Western Sky Community Care. Western Sky Community Care works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. The PDL applies to drugs you receive at retail pharmacies or mail order. Western Sky Community Care's PDL is continually evaluated by the Pharmacy and Therapeutics Committee to promote the appropriate and cost-effective use of medications.

To view the Preferred Drug List, visit the Manuals and Forms page.

You can request a copy of the Preferred Drug List by calling Member Services at 1-844-543-8996 (TTY: 711).

Specialty Drugs

A specialty drug is a prescription drug that requires special handling, administration or monitoring. These are usually only ordered through a specialty pharmacy.

If you are unsure whether your current medication is a specialty drug, please review our Specialty Pharmacy Program. It has a list of specialty drugs, plus more information about them.

Your specialty pharmacy is AcariaHealth. They can be reached at 1-800-511-5144.

How Do I Get Medications?

You can have your prescriptions filled at a network pharmacy. At the pharmacy, you will need to give the pharmacist your prescription and your Western Sky Community Care ID Card. If you need help finding a pharmacy near you, call us at 1-844-543-8996 (TYY: 711), or check online.

Can I Get a Prescription with More Than a 30-day Supply?

Certain drugs are considered maintenance medications because they are used to treat long-term conditions or illnesses. If the drug you take is part of the Maintenance Drug Program, you may receive up to 100-day supply at specific retail pharmacies.

Members can also obtain a 100-day supply (3-month supply) of maintenance medications filled at one time. It’s important to know that not all of our pharmacies are able to fill a 100-day supply, so please check this list of participating pharmacies prior to taking your 3-month prescription to them.

Maintenance Medications Up to 100 Days (PDF) Coming Soon