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Pharmacy

Effective January 1, 2020, the Pennsylvania Department of Human Services (DHS) implemented a statewide preferred drug list — PDL (PDF). This implementation required all Medical Assistance managed care organizations (MCOs) in the physical health HealthChoices and Community HealthChoices plans to move to the mandated statewide PDL.

Please use the following links to find additional information on the DHS PDL and the AmeriHealth Caritas Pennsylvania Supplemental Formulary:

Opioid treatment resources

AmeriHealth Caritas Pennsylvania continues to carefully review and update our requirements for opioid prescriptions. Our collaborative goal with you is to ensure that our members are receiving the correct treatment for their pain and that opioid utilization is managed and monitored appropriately. We will continue to provide you with the most up-to-date information and resources to attain that goal.

Opioid-related prior authorization request forms:

Opioid treatment information

State resources:

Plan resources:

Latest updates

Did you know you can now submit all pharmacy prior authorization requests online? Our Online Prior Authorization Request Form is fast, easy and best of all, requires no user IDs or passwords. Remember to bookmark this page for future reference.

Pharmacy prior authorization

Pharmacy prior authorizations are required for pharmaceuticals that are not in the formulary, not normally covered, or which have been indicated as requiring prior authorization.

Don't wait until you run out. Get automatic refill reminders in the member portal.