Pharmacy

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.

PA Forms

 

Medical Pharmacy: Buy and Bill Services

  • For medication administered at an office or facility and billed on a medical claim (CMS1500 or UB40), please submit authorization requests through Utilization Management using the GA Outpatient Prior Authorization Fax Form