Amerigroup. An Anthem Company.

New Jersey Providers

Clinical pharmacy policies

Drug coverage policies are based on medical necessity considerations subject to applicable benefits. These documents assist with medical necessity coverage decisions, may include state-specific guidance regarding coverage and do not constitute medical advice. Benefit determination is based on the applicable contract language and/or state requirements.

These policies are not a guarantee of coverage. Contract language or state requirements will prevail when there are conflicts with any medication coverage policy. In all cases, Medicaid contracts or Centers for Medicare & Medicaid Services requirements supersede policy criteria.

Provider tools & resources

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