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.
Biopharmaceutical Pharmacy Program (PDF)
2018 Preferred Drug List Updates
- 2018 Q2 Drug List Updates Addition (PDF)
- 2018 Q2 Drug List Updates (PDF)
- 2018 Q1 Drug List Updates (PDF)
2017 Preferred Drug List Updates
- 2017 Q4 Drug List Updates Addition (PDF)
- 2017 Q4 Drug List Updates (PDF)
- 2017 Q3 Drug List Updates (PDF)
- 2017 Q2 Drug List Updates (PDF)
- 2017 Q1Drug List Updates (PDF)
2016 Preferred Drug List Updates
- 2016 Q4 Drug List Updates (PDF)
- 2016 Q3 Drug List Updates (PDF)
- 2016 Q2 Drug List Updates (PDF)
- 2016 Q1 Drug List Updates (PDF)
2015 Preferred Drug List Updates
2014 Preferred Drug List Updates
- 2014 Drug List Updates - All (PDF)
- Medicaid Specialty Preferred Drug List (PDF)
- Suboxone Prior Authorization Form (PDF)
- Pharmacy Preferred Drug List Change Request Form (PDF)
AcariaHealth
Envolve Pharmacy Solutions
- Universal Retail Medication Prior Authorization Form (PDF)
- ATC Appropriate Use and Safety Edits (PDF)
Contact Information:
Prior Authorization Fax 1-866-399-0929
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 Referral Form: 2017-2018 (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.
17P or Makena