Pharmacy
Absolute Total Care is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Absolute Total Care members. Absolute Total Care covers prescription medications and certain over-the-counter medications with a written order from an Absolute Total Care provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.
Use our Medicaid Preferred Drug List (PDF) to find more information on the drugs that are covered.
Effective May 1, 2015: Copays will be removed for certain asthma, COPD and diabetes medications. View our Asthma, COPD and Diabetes Preferred Drug List Medications (PDF) to view the list of qualifying drugs.
Effective July 1, 2017: Absolute Total Care will waive copays for all members who get a prescription for a smoking cessation medication that is on the Preferred Drug List.
Effective July 1, 2017: The monthly prescription limit will be removed.
Effective April 1, 2018: All opioids (excluding exemptions) will be limited to an initial five (5) day supply.
Effective August 1, 2019: All opioids (excluding exemptions) will be limited to an initial seven day supply.
Biopharmaceutical Pharmacy Program (PDF)
2021 Preferred Drug List Updates
- Drug List Updates - Effective January 2021 (PDF)
- Drug List Updates - Effective February 2021 (PDF)
- Drug List Updates - Effective July 2021 (PDF)
2020 Preferred Drug List Updates
- Q4 2020: Drug List Updates (PDF)
- Q3 2020: Drug List Updates (PDF)
- Q2 2020: Drug List Updates (PDF)
- Q1 2020: No updates
AcariaHealth
Envolve Pharmacy Solutions
Contact Information
- Prior Authorization Fax: 1-833-982-4001
- Prior Authorization Phone: 1-866-399-0928
- Clinical Hours 11 a.m. to 8 p.m. (EST), Monday through Friday
Specialty Medications
- Specialty Drug Prior Authorization Form (PDF)
- Synagis Letter (PDF)
- Synagis Prior Authorization Form: 2020-2021 (PDF)
- Synagis Administration Policy (PDF)
All prior authorization requests should be faxed to Absolute Total Care at 1-855-865-9469. For more information, call 1-866-433-6041. All requests will be reviewed within 24 hours from the time a valid request has been received.