Four axes from current statute and agency guidance. Teal bar = substitution/assistance/access in place; amber = permissive or absent.
| Generic substitution mandate | Mandatory by statute |
| State Pharmaceutical Assistance Program | HoosierRx |
| 90-day fills permitted | Allowed |
| PMP mandatory prescriber query | Required by statute |
Indiana mandates generic substitution. Under Ind. Code § 16-42-22-7, a pharmacist shall dispense a less expensive interchangeable drug product unless the prescriber has written "brand medically necessary" or "dispense as written" on the prescription. The substitute must be FDA AB-rated. The pharmacist must inform the patient.
The Indiana Family and Social Services Administration (FSSA) maintains the Indiana Medicaid Preferred Drug List. Most members are enrolled in Hoosier Healthwise, Healthy Indiana Plan (HIP), or Hoosier Care Connect managed-care plans (Anthem, CareSource, MDwise, MHS, UnitedHealthcare), which must cover all PDL drugs. Non-preferred drugs require prior authorization.
Preferred Drug List: View current PDL
Prior authorization contact: Indiana Medicaid Pharmacy: 1-866-879-0106
Indiana operates HoosierRx, a Medicare-recognized SPAP for residents 65+ with income at or below 150% FPL who are enrolled in Medicare Part D and not eligible for Medicaid. HoosierRx pays a portion of the Part D premium for eligible enrollees (up to a state-set maximum). HoosierRx is administered by the FSSA Division of Aging and counts as creditable Medicare coverage.
Eligibility: Age 65+, IN resident, enrolled in Medicare Part D with income at or below 150% of the Federal Poverty Level (FPL). Must not be on Medicaid.
Indiana permits 90-day fills of non-controlled chronic medications at retail and mail-order pharmacies. Out-of-state pharmacies must hold an Indiana Nonresident Pharmacy permit from the Board of Pharmacy. Indiana requires e-prescribing for controlled substances under Ind. Code § 16-42-19-7.1. Federal CSA refill limits apply.
Indiana operates INSPECT, the Indiana Scheduled Prescription Electronic Collection and Tracking program. Under Ind. Code § 35-48-7-11.1, prescribers must check INSPECT before issuing any opioid or benzodiazepine prescription. Dispensers must report controlled-substance dispensing within 24 hours.
PMP portal: Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT)
Indiana hosts a substantial 340B network including IU Health, Eskenazi Health, Community Health Network, FQHCs throughout the state, and Ryan White clinics. Uninsured Indianans may access discounted outpatient drugs by establishing care at a covered entity. Use HRSA OPAIS filtered to Indiana.
Find a 340B clinic in Indiana: HRSA OPAIS database (IN filter)
Our sister site OmniRx maintains a federal-side patient assistance program directory covering manufacturer PAPs, foundation copay assistance, GoodRx-style discount cards, and 340B locators applicable nationwide.
Once the law side is clear, the next question is which pharmacy actually has the cheapest fill. Use the RxGrab Pharmacy Finder to compare CostPlus Drugs, Costco, Walmart, Amazon Pharmacy, and other discount pharmacies on your specific medication, and read our generic vs brand explainer for the bioequivalence rules behind every substitution.
Yes by default they must under Ind. Code § 16-42-22-7, unless your prescriber wrote "brand medically necessary" or "dispense as written."
HoosierRx is Indiana's SPAP for residents 65+ with income at or below 150% FPL, enrolled in Medicare Part D and not on Medicaid. It pays a portion of the Part D premium. Apply through FSSA Division of Aging.
Both use the unified Indiana Medicaid PDL via managed-care plans. HIP (Healthy Indiana Plan) is the Medicaid expansion program; Hoosier Healthwise covers traditional Medicaid populations. Drug coverage rules are largely the same.
Yes for any opioid or benzodiazepine prescription under Ind. Code § 35-48-7-11.1.