Pharmacy
Arizona Complete Health is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Arizona Complete Health members.
Arizona Complete Health covers prescription medications and certain over-the-counter medications with a written order from an Arizona Complete Health provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.
Finding your medication(s) on the Drug Lists
- You can search by the drug name.
- The lists include drugs that are generally covered
Arizona Complete Health-Complete Care Plan has three approved drug lists (formularies); Integrated, Behavioral and Crisis. You can view the drug lists using the following links:
- Arizona Complete Health-Complete Care Plan Integrated Preferred Drug List (PDF)
- Arizona Complete Health-Complete Care Plan Crisis Preferred Drug List (PDF)
- Arizona Complete Health-Complete Care Plan Behavioral Health Preferred Drug List (PDF)
- Behavioral Health Drug List (BHDL) is ONLY for the following members:
- Non-Title 19/21 persons determined to have a serious mental illness (SMI)
- Non-Title 19/21 children/adolescents determined to have a serious emotional disturbance (SED)
- Behavioral Health Drug List (BHDL) is ONLY for the following members:
- Substance Abuse Block Grant (SABG) Medication List - English (PDF)
- Arizona Complete Health OTC Drug List for Dual Eligibles - English (PDF)
Machine-Readable File (JSON)
- Arizona Complete Health Integrated Preferred Drug List Machine Readable File (JSON)
- Arizona Complete Health Behavioral Health Preferred Drug List Machine Readable File (JSON)
Prescription Prior Authorization Requests
To submit a prior authorization electronically, use CoverMyMeds.
Pharmacy Prior Authorization Fax Form (PDF)
Oncology Prior Authorization Requests
Pre-approval Process
The requesting physician must complete an authorization request using one of the following methods:
- Logging into the NCH Provider Web Portal: https://my.newcenturyhealth.com
- Calling 1-877-624-8601 (Monday – Friday 5 a.m. to 5 p.m. PST)
- Faxing the authorization form to 1-877-624-8602
Please note:
Inpatient requests for chemotherapy should continue to be submitted via the Arizona Complete Health’s Secure Provider Portal.
Ambetter from Arizona Complete Health pharmacy information is available using the following link:
Ambetter from Arizona Complete Health Pharmacy
Wellcare by Allwell Health Formularies
Covering Year 2022
Covering Year 2021
- 2021 Allwell from Arizona Complete Health Formulary
- 2021 Coverage Determination information
- 2021 Prior Authorization/Step therapy/Quantity Limit info
Covering Year 2020
Electronic Prior Authorization Submissions
Submit your prior authorization (PA) requests electronically through our preferred solution CoverMyMeds. Electronic prior authorization (ePA) automates the PA process making it a quick and simple way to complete PA requests. The ePA process is HIPAA compliant and enables faster determinations. You may also use this link to track ePA requests.
Other Resources
- Arizona Controlled Substance Prescription Monitoring Program website
- ASHP Drug Shortages Resource Center
- Biosimilar Tool Kit
- Clinical and Payment Policies
- Opioid Training Tool Kit
- Pharmacy Provider Pocket Guide (PDF)
- PMA.3.8.5 Minimum Lab Monitoring Psychotropic Medications (PDF)
- Quarterly Drug Therapy or Disease State Education