Tailored Plan Medicaid Member Pharmacy Benefits


Medications to Help in Treatment and Recovery

Please Note: Pharmacy Benefits will start for Tailored Plan Medicaid members only in July 2024.

Trillium works with PerformRx to oversee the pharmacy benefit plan for Trillium Tailored Plan members. They provide access to medications prescribed by behavioral and physical health prescribers. Medications can help members improve their quality of life. Members in recovery or experiencing a physical health condition may see better outcomes.  

How to access medications during a disaster or emergency: 

Trillium will help members to fill an emergency supply of medications should a state of emergency be declared.  In addition, certain members can, on request, get the maximum extended day supply of their prescriptions. Your care manager will have more information when an emergency declaration is active. 

Pharmacy Benefits

  • Prescription drugs
  • Some medicines sold without a prescription (also called “over-the-counter”), like allergy medicines.
  • Insulin and other diabetic supplies like syringes, test strips, lancets and pen needles.
  • Items to help stop smoking, including over-the-counter products.
  • Emergency contraception.

Available Medications

The Trillium Tailored Plan covers medications on the drug formulary established by NCDHHS. A drug formulary is the list of all medications covered by a health plan. This list includes generic (such as acetaminophen instead of Tylenol®) and brand name prescription drugs covered by the Tailored Plans. The plan covers all brand medications if a generic substitution is not available. In most cases, a generic drug will be available. The Medications are classified on the  Preferred Drug List Preferred (PDL) as Preferred, Non-Preferred or Non-PDL.

Members can call Member and Recipient Services at 1-877-685-2415 for printed version of the drug formulary to be mailed to them or to ask questions.

PerformRx updated the searchable formulary below each day. You can search the formulary for prescription limits, medications requiring prior authorization, and more:

Medication Look Up Tool

You can search for any medications that are covered here:

We also provide a Trillium Pharmacy Lock-in Program that helps identify members who are at risk for possible overuse or improper use of pain medications (opioid analgesics) and nerve medications (benzodiazepines and certain anxiolytics).

Pharmacy Locator

Use the pharmacy location tool to find a pharmacy near you:

Member Pharmacy Portal

Members can view their pharmacy benefits and coverage information. This website is separate from Trillium and you will need to provide your Medicaid Member ID in order to register to use the website.


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