Pharmacy Benefits & Services

DAKOTACARE provides a variety of pharmacy benefit options. Review the Master Contract/Policy, Certificate of Coverage or Plan Documents to understand the pharmacy benefits and services available through a specific DAKOTACARE health plan.

• State of South Dakota Health Plan members, visit http://benefits.sd.gov for information on the pharmacy services covered by your plan.
• South Dakota Risk Pool members: login to the member portal to find pharmacy services available to you.
• For all other members:
  • Pharmacy locator
  • Preventive drugs list
  • Preauthorization requirements for pharmacy services and drugs

Drug Formulary Lists

Review the Master Contract/Policy and the DAKOTACARE drug formulary links below to find out which drugs are covered by each plan. For questions about pharmacy benefits or the drug formulary that applies to a specific plan member, contact DAKOTACARE Customer Service at (800) 325-5598

• DAKOTACARE Employer Group Plan Drug Formulary (pdf) – effective 10/1/18 for members of fully insured (employer-sponsored) group plans
• DAKOTACAREONE Individual Plan Drug Formulary (pdf) – effective 10/1/18 for those who purchased individual coverage

Online and Mail-Order Prescriptions

DAKOTACARE’s pharmacy benefit helps employees conveniently manage and order prescriptions online—day or night. Whether ordering online or choosing the mail-order option, prescriptions are delivered safely and quickly to the employee’s designated address. The easy sign-up process uses member information to register online.

• Mail-Order Prescriptions – Sign up to receive prescriptions via mail