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.

• 2018 Preferred Drug List (PDF)
• 2019 Preferred Drug List (PDF)

As part of our commitment to provide the most value to our members, we are always reviewing our Ambetter drug lists. There were no updates to the formulary during the second quarter. To view last quarter’s updates please review the Ambetter Drug List Updates (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