Pharmacy

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 Integrated Preferred Drug List (PDF) - Medicaid - (Revised 11/1/18)
• Arizona Complete Health Crisis Preferred Drug List (PDF) - Medicaid
• Arizona Complete Health Behavioral Health Preferred Drug List (PDF) - Medicaid -  (Revised 11/1/18)
  • Behavioral Health Drug List (BHDL) is ONLY for the following members:
    • Non-Title 19/21 persons determined to have a serious mental illness (SMI)
    • T19/21 Child/Adolescent, T19/21 CMDP and all T19/21 DDD members

Prescription Prior Authorization Requests

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

• Pharmacy Prior Authorization Fax Form (PDF)

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

Coming Soon