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Coverage Status

State-by-State Medicaid Formulary Coverage

All 50 states and DC are available on FormCheckRx. Michigan is fully verified by a licensed PharmD against the official SPDL. All other states are in active beta — results are available but should be verified against the applicable plan PBM for critical coverage decisions until PharmD verification is complete.

51
States + DC available
1
PharmD-verified states
224
MCOs mapped
1,233+
Formulary entries
PharmD Verified — reviewed against official state PDL by licensed pharmacist Beta — available, AI-generated, cross-reference with plan PBM for critical decisions
State Status PDL Structure MCOs PDL Update Frequency Notes
MichiganVerifiedSingle PDL (SPDL)11Monthly off-cycle updates2025–2026 SPDL — fully validated
AlabamaBetaMCO-individual4Quarterly
AlaskaBetaFFS + Managed Care2Quarterly
ArizonaBetaMCO-individual6Quarterly
ArkansasBetaState-directed PDL3Quarterly
CaliforniaBetaFFS carve-out (2022)22MonthlyPharmacy benefit carved out of MCOs
ColoradoBetaMCO-individual5Quarterly
ConnecticutBetaMCO-individual3Quarterly
DelawareBetaMCO-individual3Quarterly
District of ColumbiaBetaMCO-individual3Quarterly
FloridaBetaState PDL (AHCA P&T)10Quarterly (P&T)Next update Apr 1, 2026
GeorgiaBetaMCO-individual6Quarterly
HawaiiBetaMCO-individual2Quarterly
IdahoBetaState PDL2Quarterly
IllinoisBetaMCO-individual8Quarterly
IndianaBetaMCO-individual4Quarterly
IowaBetaMCO-individual3Quarterly
KansasBetaMCO-individual3Quarterly
KentuckyBetaSingle PBM (SPBM)5MonthlyState-directed single PBM model
LouisianaBetaSingle PBM (SPBM)5MonthlyState-directed single PBM model
MaineBetaMCO-individual2Quarterly
MarylandBetaMCO-individual5Quarterly
MassachusettsBetaMCO-individual4Quarterly
MinnesotaBetaMCO-individual6Quarterly
MississippiBetaUniversal PDL (SSDC)4MonthlySovereign States Drug Consortium
MissouriBetaFFS carve-out3Quarterly
MontanaBetaFFS + MCO2Quarterly
NebraskaBetaMCO-individual3Quarterly
NevadaBetaMCO-individual3Quarterly
New HampshireBetaMCO-individual3Quarterly
New JerseyBetaMCO-individual5Quarterly
New MexicoBetaMCO-individual4Quarterly
New YorkBetaFFS carve-out (NYRx)8MonthlyNYRx state pharmacy program
North CarolinaBetaState PDL (P&T)5Quarterly + off-cycleGLP-1 changes Oct–Dec 2025
North DakotaBetaFFS + MCO2Quarterly
OhioBetaSingle PBM (SPBM)5MonthlyODM drug lookup tool available
OklahomaBetaState PDL4Quarterly
OregonBetaMCO-individual5Quarterly
PennsylvaniaBetaStatewide PDL (DHS P&T)7Annual + off-cycleHealthChoices + CHC MCOs
Rhode IslandBetaMCO-individual2Quarterly
South CarolinaBetaSingle PDL (Jul 2024)5QuarterlySCDHHS unified PDL effective Jul 2024
South DakotaBetaState PDL2Quarterly
TennesseeBetaFFS carve-out4Quarterly
TexasBetaState PDL (VDP)20MonthlyTexas Vendor Drug Program; MCOs required to follow
UtahBetaMCO-individual3Quarterly
VermontBetaState PDL1Quarterly
VirginiaBetaMCO-individual6Quarterly
WashingtonBetaMCO-individual4Quarterly
West VirginiaBetaFFS carve-out3Quarterly
WisconsinBetaFFS carve-out4Quarterly
WyomingBetaFFS + MCO2Quarterly

PharmD Verified — Michigan results are reviewed by a licensed pharmacist against the 2025–2026 Michigan Single Preferred Drug List (SPDL).   Beta — All other states are available but results are AI-generated from primary state sources. For critical coverage decisions, verify against the applicable plan PBM until PharmD verification is complete.   PDL Structure notes: States with a Single PDL or FFS carve-out maintain one unified formulary across MCOs. States with MCO-individual PDLs have separate formularies per plan — FormCheckRx retrieves each plan's current PDL simultaneously. MCO counts are approximate and change as states add or change managed care contractors.