Amerigroup formulary drug list

Some prescriptions require prior authorization and may have limitations based on age or the amount of medicine prescribed. Iowa Total Care also covers certain over-the-counter medications with a prescription from an Iowa Total Care provider.

If you have questions about which drugs or prescriptions are covered by your Medicaid plan, we lay out your Iowa Medicaid prescription drug coverage below and how to find a pharmacy within the Iowa Medicaid network. Iowa Total Care covers certain prescription drugs and over-the-counter drugs when prescribed by an Iowa Total Care provider. The pharmacy program does not cover all drugs, however. Some drugs require prior authorization and may have limitations on age, dosage or maximum quantities.

Iowa Total Care works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. The PDL applies to drugs you receive at retail or mail order pharmacies. A specialty drug is a prescription drug that requires special handling, administration, or monitoring. These are usually only ordered through a specialty pharmacy. If you are unsure whether your current medication is a specialty drug, please review our Specialty Pharmacy Program.

It has a list of specialty drugs, plus more information about them. You can have your prescriptions filled at a pharmacy in the Iowa Total Care network. In addition to approval criteria for nonpreferred products, some drugs have additional criteria that must be met. Note: For continuity of care, all plans will use the same PA criteria, step therapy edits, and quantity limits developed by HCA.

If you can't find the versions you're looking for, email us applehealthpharmacypolicy hca. Note: For information on billing and rates, the Apple Health PDL, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates webpage. See what drugs are preferred and whether they need a prior authorization PA. How to use the Apple Health PDL Preferred drugs within a chosen therapeutic class are selected based on clinical evidence of safety, efficacy, and effectiveness.

Related forms and publications Emergency fill policy. Related links Request a pharmacy prior authorization Barcoded document submission cover sheets Apple Health Medicaid drug coverage criteria Implementation status reports under Agency reports.

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