We are committed to providing appropriate, high-quality, and cost-effective drug therapy to all Ambetter members. Use our Preferred Drug List to find more information on the drugs that Ambetter covers.

For questions regarding pharmacy services contact us at 877-725-7749.

• 2023 Formulary/Prescription Drug List (PDF)
  
• 2022 Preferred Drug List (PDF)
• 90-Day Extended Supply Medications (PDF)

PA Forms

• CoverMyMeds 
  
• Prior Authorization Request Form for Non-Specialty Drugs (PDF)