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.

• 2022 Preferred Drug List (PDF).
  
• 2021 Preferred Drug List (PDF).
• 2020 Preferred Drug List (PDF)
• 90-Day Extended Supply Medications (PDF)

PA Forms

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