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Medicaid Formularies

Amerigroup Formulary: Medications included in the Amerigroup formulary are reviewed and approved by the Amerigroup Pharmacy and Therapeutics Committee, which includes practitioners and pharmacists from the Amerigroup provider community.

Non-Formulary Drugs: Medications not listed in the formulary are considered to be non-formulary and are subject to prior authorization. Some medications listed may have additional requirements or limitations of coverage. These requirements and limits may include prior authorization, quantity limits, age limits or step therapy.

Generic Drugs: Additionally, if a medication is available as a generic formulation, this will be Amerigroup' s preferred agent, unless otherwise noted. If a brand name medication is requested when a generic exists, a prior authorization request will need to be submitted.

Drug Coverage: Questions about coverage of a certain product, please contact us at 1-800-454-3730.

Search for name brand and generic drugs
that are on your formulary:

Prior authorizations

For Georgia, Maryland, New Jersey or Washington members: Complete our Pharmacy Prior Authorization form and follow the submission instructions provided on the form.

For Texas members: If you have verified through your state formulary that prior authorization is needed, visit our Pharmacy Prior Authorization page and choose your state to find the correct prior authorization form.