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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:

The AHCCCS Pharmaceutical and Therapeutics Committee recently adopted the following changes to the state’s PDL, effective October 1st, 2020.

2021 Medicaid PDL Updates (PDF) 

Prescription Prior Authorization Requests

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

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.

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

Other Resources

 

Pharmacy Policies for Medicaid and Ambetter