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.

Medicaid Preferred Drug Lists

Pharmacy Prior Auth Criteria

View AHCCCS Pharmacy Information

*Arizona Complete Health-Complete Care Plan utilizes Prior Authorization criteria that has been reviewed and approved by AHCCCS.

**Additional PA criteria may apply. For drug specific PA criteria not included on the AHCCCS Fee-For-Service PDF (link above), please call provider services at 888-788-4408 to request a copy of the PA criteria.

Oncology Prior Authorization Requests (Outpatient)

The requesting physician must complete an authorization request using one of the following methods:

Please note:
Inpatient requests for chemotherapy should continue to be submitted via the Arizona Complete Health’s Secure Provider Portal.

Electronic Prescription 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.

Pharmacy Prior Authorization Fax Form (PDF)

Medical (Biopharmacy) Prior Authorization Fax Form (PDF)

Submit a PA Request

Other Resources

 

Marketplace and Medicare Preferred Drug Lists