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Extension of Pharmacy Benefit to Cover Over-the-Counter Cough & Cold Medications for Adults

The Department of Human Services (DHS) recently announced it will now pay for prescribed over-the-counter (OTC) cough and cold medications for Medicaid (Medical Assistance or MA) enrollees age 21 and over.  Previously, MA only covered over-the-counter cough and cold medications for children under age 21.  During the COVID-19 emergency, individuals of any age can access these medications if they have a prescription from their doctor. 

This change went into effect on March 1, 2020 and will remain in effect until the end of the COVID-19 emergency declaration by the president. 

As a reminder, there are no copayments for medications related to the treatment of COVID-19 and its symptoms, including over-the-counter cough and cold medications, as well as acetaminophen, antidiarrheals, antiemetics, antihistamines (second generation), asthma/COPD medications, ophthalmic antihistamines/decongestants, ophthalmic lubricants, and oral NSAIDs. 

For more information about pharmacy changes during COVID-19, see the following MA Bulletin: Pharmacy Services for MA Beneficiaries Related to the COVID-19 Public Health Emergency