Prescriptions

WellSense is committed to providing quality and affordable medications for MassHealth members through our prescription drug benefit.

Our prescription drug benefit offers:

• Coverage of thousands of medications
• Coverage of nondrug pharmacy items
• Coverage of some over-the-counter drugs like aspirin or certain allergy medicines
• Affordable copays for generic medications
• Choose from more than 1,000 pharmacies through Massachusetts to get your prescriptions filled
• Get specialty medications, like injectable and biotech drugs, that are used treat members with rare or chronic conditions

Effective April 1, 2024, MassHealth will apply a $0 copay to all drugs for members.

Check to see if your drug is covered

MassHealth has updated its list of covered drugs, effective 4/1/2023. Please use the link below to check if your drug is covered by the pharmacy benefit.

Specialty drugs

Certain medications, like drugs provided to members living with chronic health conditions, must be obtained through a specialty pharmacy.

Click here to view the Specialty Drug List to check if your drug is covered.

Information on using the MassHealth Drug List

The MassHealth Drug List is a listing of all of the drugs covered by MassHealth and WellSense.  The columns of the drug list can help to determine:

• If prior authorization is required
• Drug specific notes about coverage rules and requirements (scroll to the end of the MH Drug List to learn more about the Drug Notes)

To search for a drug:

• Select a letter to see drugs listed by that letter -OR-
• Enter the name of the drug you wish to search for
  • Please note: Any drugs that do not appear on the MassHealth Drug List require prior authorization

Prescription quantities

WellSense requires a 90-day supply be dispensed on certain drugs, and allows up to a 90-day supply on others.  Select drugs, like specialty drugs, are limited to a 30-day supply.  Visit the MassHealth Drug List for more information - check the Drug Notes to find the day-supply for your drug:

• Mandatory 90-Day Supply (M90): After dispensing up to a 30-day supply initial fill, dispensing a 90-day supply is required.
• Allowable 90-Day Supply (A90):  Dispensing in up to a 90-day supply is allowed.
• Limited to 30-Day Supply (all others): Limited to dispensing a 30-day supply.

Picking up prescriptions

*Please review Your Benefits for more details on services and medications that are covered by your plan. You can Find a Provider in our network, see our Privacy Policy and learn how we make sure you get the right care at the right time with our Utilization Management Policy.