We are committed to providing appropriate, high-quality, and cost-effective drug therapy to all Ambetter Health members. Use our Preferred Drug List to find more information on the drugs that Ambetter Health covers.

• 2025 Formulary/Prescription Drug List (PDF)
  
• 2025 Formulary/Prescription Drug List- Connected Silver (PDF)
• 2025 Formulary Changes (PDF)
• 2024 Formulary/Prescription Drug List (PDF)
  
• 2024 Formulary/Prescription Drug List  - Connected Silver (PDF)
• 90-Day Extended Supply Medications (PDF)
  

PA Forms

• Prior Authorization Request Form for Non-Specialty Drugs (PDF)

CoveredMD

Ambetter’s preferred method for submitting pharmacy prior authorization requests is through CoverMyMeds®.

CoverMyMeds is the fast and simple way to review, complete, and track prior authorization requests. Their electronic submissions process is safe, secure, and available for providers and their staff to use at no cost.

CoverMyMeds Prior Authorization Tool