Pharmacy Information
Pharmacy information for providers including contact information and formulary details can be found below. Pharmacy benefits are provided through IngenioRx.
Medicaid Preferred Drug List (Formulary)
Please refer to the Amerigroup Community Care Preferred Drug List (formulary) when prescribing for our members. The formulary lists the brand name or generic name of a given drug.
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.
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:
Amerigroup Pharmacy PA Center
Hours: Monday – Friday 7:00 a.m. – 11:00 p.m.; Saturday – Sunday 8:00 a.m. – 6:00pm
Phone:
1-833-293-0659
Prior Authorization for Retail Pharmacy/Prescription Drugs Fax:
1-844-490-4736
Prior Authorization for Medical Injectables Fax:
1-844-490-4870
Specialty Drugs
Specialty drugs may be covered as a pharmacy benefit or an outpatient medical benefit. Providers should refer to our searchable formulary for pharmacy benefit drugs and the Prior Authorization Lookup Tool for medical benefit drugs to determine if a prior authorization is needed.
Once the PA has been submitted and approved, providers should send the prescription to one of the following in-network specialty pharmacies:
IngenioRx Specialty Pharmacy
Handles specialty drugs given as a pharmacy benefit.
Phone:
1-833-255-0646
Fax:
1-833-263-2871
CVS CareMark Specialty Pharmacy
Handles specialty drugs covered as a medical benefit.
Phone:
1-877-254-0015
Fax:
1-866-336-8479
IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Amerigroup Community Care. CVS is an independent company providing pharmacy services on behalf of Amerigroup Community Care.
Find a Pharmacy
Find an in-network pharmacy using the pharmacy search tool:
Related resources
- Common OTC Medications List
- Medication Precertification Requests in Availity
- National Drug Code FAQs
- Prior Authorization for Pediatric Antipsychotic Medication Guide
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