Drug Formularies

Members who have prescription drug coverage through AmeriHealth Pennsylvania are covered under one of several formulary-based prescription drug benefit programs. These programs are designed to provide physicians with a range of prescribing options while maintaining cost-effectiveness for AmeriHealth members.

Use the following links for more information about the various AmeriHealth prescription drug benefit programs:

Note: Some members may have prescription drug coverage under the Standard Drug Program Formulary. Those members should review formulary information by logging on to amerihealthexpress.com, our secure member website.

Effective Use of the Formulary

Help your AmeriHealth patients make the most of their health care dollars. Before prescribing a medication to an AmeriHealth member, please consider whether the drug is included in the formulary used in their prescription drug benefit program. If a member is currently taking a drug not on the formulary, you may be able to help him or her save money by changing the prescription to a generic equivalent or to a similar drug on the formulary.

However, the choice is still yours. Regardless of whether a drug is in the formulary or not, you may prescribe any covered medication at your discretion. Each of the links above provides further information on what drugs are included in each respective formulary.

Prescription Drug Guidelines

Learn how our prescription drug benefit programs use safe prescribing procedures to give members access to the drugs they need while keeping them safe.

FutureScripts® Specialty Pharmacy

AmeriHealth offers two preferred options for participating providers to request fulfillment of specialty pharmacy drugs for patients with an AmeriHealth prescription drug benefit: Optum® and PerformSpecialty®. Optum and PerformSpecialty supply specialty drugs eligible under the AmeriHealth member's prescription drug benefit, which is administered by FutureScripts®.

Providers who are considering beginning an AmeriHealth member on a new specialty drug therapy covered under the pharmacy benefit can use the following information:

  • Optum. Providers can call Optum® Specialty Pharmacy and Optum® Infusion Pharmacy at 1-855-427-4682 to enroll the member. Members can reach Optum to have a prescription filled by calling 1-855-427-4682 or by visiting the Optum website.
  • PerformSpecialty. Providers can call the PerformSpecialty Patient Care Line at 1-855-287-7888 to enroll the member. Members can reach PerformSpecialty to have a prescription filled by calling their Patient Care Line at 1-855-287-7888 or by visiting the PerformSpecialty website.