Member Important Updates on NYRx, the Medicaid Pharmacy Benefit

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Subject: Important Updates on NYRx, the Medicaid Pharmacy Benefit
Dear Members,

We hope this communication finds you well. We have news about NYRx. Your health matters to us, and we want to give you the latest information to help you manage your drugs and supplies.

What is NYRx?
NYRx is your New York Medicaid pharmacy benefit. NYRx covers your prescription drugs and supplies, and some over-the-counter items. To see what's covered under the NYRx program, visit NYRx, the Medicaid Pharmacy Program Member Resources.
Key Updates
Extra Information Needed for Certain High-Cost Medicines:

Starting March 19, 2026, the following drugs will no longer be covered by NYRx without your doctor requesting approval. These drugs have alternate options available that do not require more information. Talk to your doctor or pharmacist about alternative drugs that do not require approval.

Drugs that will need this additional information:

Bucapsol 7.5mg, 10mg, 15mg Capsule
Clindamycin Phosphate 1% (Gen Clindagel) Gel
Clobetasol 0.025% Cream
Dexchlorpheniramine 2mg/5ml Solution
Ertaczo 2% Cream
Fenopron 300mg Capsule
Gabarone 100mg, 400mg Tablet
Ketoprofen 75mg Capsule
Meloxicam 7.5mg/5ml Suspension
Metaxalone 640mg Tablet
Metoprolol Tartrate 12.5mg Tablet
Nitrofurantoin 50mg/5ml Suspension
Pokonza 10mEq Packet
Sdamlo 2.5mg, 5mg, 10mg Powder for Oral Solution
Tetracycline 500mg Tablet

How will you get these drugs?
You may still be able to get these drugs, but your doctor will have to submit additional information showing a clear health-related reason for use. Talk to your doctor or pharmacist to get more information.
Important Reminders
Stay Up to Date: To review current and past member notifications for NYRx, visit the 'Member Notices' section of the eMedNY member website

Important Information About Your NY Medicaid Benefits: Make sure NY State of Health has your current mailing address, phone number and email address so they can contact you about your health insurance. Update your contact information at: NY State of Health Keep Your Coverage so you know when to renew your coverage.
Questions? We're Here to Help!
If you have any questions regarding your pharmacy benefits or NYRx, please call the Medicaid Helpline at (800) 541-2831. Our agents are available:
  • Monday through Friday, 8 AM to 8 PM
  • Saturday, 9 AM to 1 PM

TTY 1-800-662-1220. We also provide help in different languages.

Thank you,

NYRx, Medicaid Pharmacy Program
New York State Department of Health