Please select the state where you practice.

Pharmacy Program

 

HealthChoice

Pharmacy Program

The Preferred Drug List (PDL) is a list of prescription drugs considered coverable by HealthChoice.

Click on the link below to view the Preferred Drug List.

Preferred Drug List (PDL) Search
Preferred Drug List  (PDF 1.44 MB)

10/1/2017 PDL Update (PDF 58.1 KB)
7/1/2017 PDL Update (PDF 132.42 KB)
4/1/2017 PDL Update (PDF 63.34 KB)
1/1/2017 PDL Update (PDF 137.74 KB)

 

Step Therapy Program 

Step Therapy (PDF 21.02 KB)


Drug Quanitity Limits 

Quantity Limits (PDF 20.11 KB)
Quantity Limits for Opioids
(PDF 132.82 KB)


Pharmacy Bulletins

Synagis Enrollment Form  (PDF 225.02 KB) 
Synagis Program  (PDF 58.92 KB)
Synagis Program 5 Doses (PDF 38.09 KB)

 

Specialty pharmacy medications covered under the member's medical benefit may be obtained through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

If you don't want to buy and bill a specialty pharmacy medication covered under the member's medical benefit, you may order it through one of the following network specialty pharmacies:

Network Specialty Pharmacy

Phone Number

BriovaRx

866-815-5338

BioScrip (offers nursing services)

• also serves as a national home infusion provider for medical benefit medications

866-788-7710

The following specialty pharmacies also provide certain types of specialty medications:

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension

800-803-2523

 

Option Care (nursing services)

Cardiovascular/Heart Failure

Enzyme Deficiency

Gaucher's Disease

Hemophilia

Immune Globulin

Makena

866-827-8203

CVS Caremark Specialty Pharmacy

Pulmonary Hypertension

800-237-2767


Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.

Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.