Pharmacy Information

Medicaid Preferred Drug List (Formulary)

Please refer to the Amerigroup Community Care Preferred Drug List (PDL) when prescribing for our members. The formulary contains preferred and non-preferred drugs listed by brand or generic name.  Non-preferred drugs are subject to prior authorization. Some drugs on the PDL may have additional requirements or limitations of coverage that will require you to contact our Pharmacy PA Center for authorization.

Drugs not listed in the formulary are considered to be non-formulary until they are reviewed for formulary placement through the P&T process.  These new drugs may be available through prior authorization or medical necessity review.  Providers may request the addition of a product to the formulary by submitting their personal request along with any supporting information using this link: Drug List Addition Request (carelonrx.com)

The PDL is reviewed and updated quarterly.  The PDL can be accessed from the links below.

• Georgia Families, PeachCare for Kids® and Georgia Families 360°SM Searchable Formulary
• Planning for Healthy Babies®: Family Planning Searchable Formulary
• Planning for Healthy Babies®: Inter-Pregnancy Care Searchable Formulary

Prior Authorization Requests

Some drugs, drug combinations, and drug doses require prior authorization (PA). To submit electronic prior authorization (ePA) requests, use CoverMyMeds. Creating an account is free.

While ePA helps streamline the PA process, you may also initiate a new PA request by calling or faxing a completed Pharmacy Prior Authorization form to Amerigroup. Please note the following contact numbers for prior authorization requests and PA form below:

Phone:

1-800-454-3730

Prior Authorization for Retail Pharmacy/Prescription Drugs Fax:

1-844-490-4736

Prior Authorization for Medical Injectables Fax:

1-844-490-4870

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