Pharmacy Services - Providers

Pharmacy Lookup

AmeriHealth Caritas new Hampshire works with providers and pharmacies across the state to help ensure our members can access their medications and prescriptions. Our members can:

•  Search an online list of in-network pharmacies with the Pharmacy Look-Up Tool
•  Explore a selection of specialty pharmacies
•  Secure emergency or transitional medications
•  Find a mail-in pharmacy
•  Assist with new member prescription instructions

Pharmacy Prior Authorization

Pharmacy prior authorizations are required for pharmaceuticals that are not in the formulary, PDL, not normally covered, or which have been indicated as requiring prior authorization. 

• Use the Prior authorization lookup tool
• Submit your pharmacy prior authorization requests online.
• See services and drugs with their prior authorization criteria
• View opioid and drug-class-specific requirements
• Find forms such as the Prior authorization drug approval form (PDF)

Pharmacy and Prescription Benefits

From state aligned preferred drugs to step therapy, tier leveled care, or unified PDL, providers can  find coverage information for [LOB] prescriptions, including:

• Look-Up tool
• State PDL
• Formulary
• Specialty Drugs
• Searchable Drug Lists
• Form

Pharmaceutical Policies

AmeriHealth Caritas NH is dedicated to providing the most comprehensive, outcomes-driven health solutions for our members. Find more information about:

• Plan vs. state policy
• Supplemental lists
• Billing rules
• Denials
• Restrictions
•  CMS billing codes for meds J-codes