• Medicare Part D

• AmeriHealth 65

• AmeriHealth Rx (NJ)

• AmeriHealth Rx (PA/WV)

• AmeriHealth Advantage (PA/WV)

• Find a Provider

• Group Plans

• Disclaimers

AmeriHealth^® Rx

Drug formulary

A formulary is a list of covered drugs selected by AmeriHealth Rx in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. AmeriHealth Rx will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at an AmeriHealth Rx network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

Drug Formulary Search

• Alphabetical Drug Name
• Drug Class

Instructions for using the formulary search tools

You can search for your drug under its drug class or by an alphabetical index. The formulary agent is listed by a green checkmark. A “G” indicator means that the drug is available as a generic and you will be responsible for your generic, Tier One copay. If there is no “G” and a green checkmark, the drug is available as a brand-name drug, and you will be responsible for your preferred brand, Tier Two copay. If your drug is not listed or there is a “NP (non-preferred)” indicator, you will be responsible for your non-preferred, Tier Three copay.

If your search results indicate that a drug is not covered, see Exceptions and Appeals to obtain an explanation of how to obtain an exception to the Part D plan’s formulary.

Download the  AmeriHealth Rx (PA/WV) Formulary Program Guide.

Generic and Brand-Name Drugs
Our plans cover both brand-name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs.

Prior Authorization Submission
Those medications not on our formulary, as well as some formulary medications, will require prior authorization. This means that your doctor will have to get approval in advance from us.

Formulary Changes
Check here for drugs recently added or removed from the formulary.

Exceptions & Appeals
If you and your doctor agree you need medication that we don’t cover and no alternative is available, you may want to appeal our decision or ask for an exception.

Transition Process
This is how we ensure your medication is not interrupted as you change over to our plan or if there are changes in your care.

Pharmacy Network
Your prescriptions are covered at more than 60,000 national chain, independent, long-term care, and home-infusion pharmacies.

Quality Assurance
Before you receive your prescription, these safety issues are checked to make sure you’re getting the right medicine.

Important information about links to other sites