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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:

Prescription Prior Authorization Requests

To submit a prior authorization electronically, use CoverMyMeds with Envolve Pharmacy Solutions.

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 Arizona Complete Health’s Secure Provider Portal at https://www.azcompletehealth.com/login.htm.  

Pharmacy dispensed chemotherapeutic and supportive agents that were previously submitted to Envolve Pharmacy Solutions or CoverMyMeds should be submitted directly to NCH.

Ambetter from Arizona Complete Health pharmacy information is available using the following link:
Ambetter from Arizona Complete Health Pharmacy

Allwell from Arizona Complete Health Formularies

Prior Authorization Criteria

Step Therapy Criteria

Quantity Limits

Refer to the List of Drugs (Formulary) for drug Requirements and Limits
2019 List of Drugs (Formulary)

Request for Medicare Coverage Determination Form

Pharmacy Policies for Medicaid and Ambetter