Pharmacy

We are committed to providing appropriate, high-quality, and cost-effective drug therapy to all Ambetter members. View the current Preferred Drug List (PDL) to find more information on the drugs that Ambetter covers.

• 2019 Preferred Drug List (PDF)

• 90-Day Maintenance Drug List (PDF)

PA Forms

• Prior Authorization Request Form for Non-Specialty Drugs (PDF)
• Prior Authorization Request Forms for Specialty Drugs