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Pharmacy

It's important to Arizona Complete Health that our members receive drug therapy that is appropriate, high quality and cost effective. We work hard to ensure you have access to safe and effective medications that are medically proven to help you get healthy and stay healthy.

Preferred Drug List

The Preferred Drug List (PDL) is the list of drugs covered by Arizona Complete Health-Complete Care Plan. Arizona Complete Health-Complete Care Plan works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered.

 

Arizona Complete Health-Complete Care Plan Comprehensive Preferred Drug List

The Arizona Complete Health-Complete Care Plan Comprehensive Drug List (PDL) includes drugs that have been reviewed and approved by a committee of doctors and pharmacists. This is not a complete listing of all covered drugs. If you need a drug that is not on the drug list, please call Arizona Complete Health-Complete Care Plan Member Services at 1-888-788-4408 (TTY/TDD:711) and ask if it is covered. If the drug is not covered, your doctor may send in a prior authorization request to cover the drug.

Visit AHCCCS to view or download:

 

    Special Note on Buprenorphine tablets:

    PA REQUIRED unless the member is pregnant or nursing.

    If the member is pregnant or nursing:
    The prescriber must note the following ICD-10 codes on the prescription:

    • 1. O09.91 - Supervision of high risk pregnancy, 1st Trimester.
    • 2. O09.92 - Supervision of high risk pregnancy, 2nd Trimester.
    • 3. O09.93 - Supervision of high risk pregnancy, 3rd Trimester.
    • 4. O09.91 - Supervision of high risk pregnancy- use for Postpartum Nursing Mothers.

    The first digit of the diagnosis code is the Letter - O and the second digit is the number, Zero - 0

    The pharmacy should use these codes when submitting the prescription to override PA requirements for this drug. 

    Arizona Complete Health-Complete Care Plan Behavioral Health Drug List

    The Arizona Complete Health-Complete Care Plan Behavioral Health Drug List (BHDL) includes the behavioral health drugs that are listed on the AHCCCS Drug List. The BHDL applies to the following members:

    • Non-Title 19 and Non-Title 21 persons with the SMI, serious mental illness, designation.
    • Non-Title 19 and Non-Title 21 children and adolescents with the SED, serious emotional disturbance, designation.
    • Title 19 or Title 21 members who are only enrolled in the Arizona Complete Health-Complete Care Plan Behavioral Health Plan.

    The BHDL is not a complete list of all drugs used to treat behavioral health conditions. If you need a drug that is not on the BHDL, you may ask your doctor or pharmacist to fax a prior authorization request to 833-546-1508 or send it electronically through CoverMyMeds.

    You also may call the Arizona Complete Health-Complete Care Plan Member Services at 1-888-788-4408 (TTY/TDY 711) if you have any questions about the medications not listed on the BHDL.

    PDF to View or Download:

      Special Note on Buprenorphine tablets:

      PA REQUIRED unless the member is pregnant or nursing.

      If the member is pregnant or nursing:
      The prescriber must note the following ICD-10 codes on the prescription:

      • 1. O09.91 - Supervision of high risk pregnancy, 1st Trimester.
      • 2. O09.92 - Supervision of high risk pregnancy, 2nd Trimester.
      • 3. O09.93 - Supervision of high risk pregnancy, 3rd Trimester.
      • 4. O09.91 - Supervision of high risk pregnancy- use for Postpartum Nursing Mothers.

      The first digit of the diagnosis code is the Letter - O and the second digit is the number, Zero - 0

      The pharmacy should use these codes when submitting the prescription to override PA requirements for this drug. 

      If you need medicine, your provider chooses a medication from our list(s) of preferred drugs.

      • Your provider writes a prescription for you. Ask your provider to make sure that the medicine is on one of the lists.
      • Take the prescription to a network pharmacy to have it filled.
      • Show your Arizona Complete Health-Complete Care Plan member ID card to the pharmacy staff.
      • Non-Title AHCCCS Enrollees assigned to AzCH-CCP can find Pharmacy Benefit details by logging into the Express Scripts website. 
      • If you paid for medications that qualify for a reimbursement, please complete the reimbursement form and fax as directed.

      How to find a network pharmacy

      • Search our directory for a network pharmacy using the Find a Provider tool. 
      • Calling Member Services at 888-788-4408 (TDD/TTY 771). Ask the representative to help you find a network pharmacy in your area.

      All prescriptions must be filled at a network pharmacy. Arizona Complete Health-Complete Care Plan does not cover prescriptions filled at other pharmacies.

      Prescription refills

      Your medicine bottle’s label says how many refills you can have. If you think you may need a refill, you must contact your provider at least five days before you run out of medicine. When you call, ask your provider about getting a refill. Your provider may want you to make an appointment before giving you a refill.

      Medication home delivery

      If you need medication home delivery services, please contact Member Services.

      Arizona Complete Health-Complete Care Plan wants you to be as healthy as possible. This includes knowing about the different medicines you need to take. To help, we have included a list of questions you should always ask your provider about a prescription.

      • Why am I taking this medicine? What is it supposed to do for me?
      • How should the medicine be taken? When? For how any days?
      • Are there any side effects or possible allergic reactions to this medicine?
      • What should I do if I have a side effect or allergic reaction?
      • What will happen if I don’t take this medicine?

      Carefully read the drug information the pharmacy gives you with your medicine. It will tell you what you should and should not do while taking the medicine. If you have questions after you get your medicine, ask to speak with the pharmacist or call your provider.

      OTC drugs are non-prescription drugs that are only covered through the prescription drug benefit if prescribed by a medical practitioner.

      If your medicine is not on our approved-drug list(s), you can:

      • Ask your provider for a similar drug that is on the list.
      • Ask your provider to ask Arizona Complete Health-Complete Care Plan to cover your drug. Your provider will go through a prior authorization process. Your provider will know how to do this.