Member Important Updates on NYRx, the Medicaid Pharmacy Benefit
- Important Updates on NYRx is also available in Portable Document Format (PDF)
| Subject: Important Updates on NYRx, the Medicaid Pharmacy Benefit | ||||||||||||||||||||||||||||||||||||||||||||||||
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| 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 member.emedny.org. |
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| Key Updates | ||||||||||||||||||||||||||||||||||||||||||||||||
| Extra Information Needed for Certain High-Cost Medicines: Starting June 4, 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: 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. |
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| Prenatal Vitamin Updates: On June 4, 2026, NYRx, the Medicaid Pharmacy Program will update prenatal vitamin coverage. Prenatal vitamins covered by NYRx meet the recommended need for Folic Acid and Iron per the United States Preventative Services Task Force (USPSTF) and American College of Obstetrics and Gynecology. The below options allow a 90-day supply and do not require prior approval. Prenatal Vitamins that will remain covered with no change:
Starting June 4, 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.
If you are taking any of these drugs, talk to your doctor or pharmacist about other prenatal vitamins that are covered by NYRx.
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| 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. |
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| Important Reminders | ||||||||||||||||||||||||||||||||||||||||||||||||
| 90-Day Supplies: Most drugs you take regularly are available as a 90-day supply. To get a 90-day supply, ask your doctor for a prescription. You can also talk to your pharmacist, who can speak to your doctor. 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 so you know when to renew your coverage. |
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| 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:
Thank you, NYRx, Medicaid Pharmacy Program New York State Department of Health |
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