The program only reimburses for prescribed drugs listed on the Reimbursable Drug Formulary. Only generic drugs are reimbursed—unless there isn't a generic available. If that's the case, it is clearly marked on the Formulary.
Reimbursable dialysis services can be received in a dialysis center, a hospital out-patient setting or at home.
The program pays for covered services after all other payment sources—including Medicare, Medicaid, private insurance, or any other health insurance—have determined and paid their share.
Costs for renal-related services that aren't reimbursed by the program or other payers are the responsibility of the client.
The client assistance limit for state fiscal year 2024-25 (July 2024 - June 2025) is $12,100 per client.