Skip to Main Content


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.

Important Pharmacy Claims Processing Change, Effective January 1, 2024

We are pleased to announce that, effective January 1, 2024, Express Scripts® will begin processing pharmacy claims for our plan members.

Express Scripts is a pharmacy benefit management (PBM) company serving more than 100 million Americans. Express Scripts Pharmacy delivers specialized care that puts patients first through a smarter approach to pharmacy services.

Members have been notified in advance and will receive a new ID card with updated pharmacy information, so that they are prepared to begin having their prescriptions filled at participating network pharmacies when this change occurs.

Providers can direct members to call the Member Services phone number listed on their ID card should they have questions about this change. Please contact your Provider Relations Representative with any additional questions.

Thank you for the care you provide to our members.


Ambetter Pharmacy Requests **Will open into new window

Use our Medicaid Comprehensive Drug Lists for more information on the drugs that are covered:

All oncology-related chemotherapeutic drugs and supportive agents will require prior authorization from New Century Health (NCH) before being administered in a physician’s office, outpatient hospital, or ambulatory setting.

This process applies to both Medical Benefit (Buy and Bill Request) AND Pharmacy Services (Retail Pharmacy)

Pre-Approval Process

The requesting physician must complete an authorization request using one of the following methods:

General New Century Health Information

Medical Benefit Buy & Bill requests are for medications that will be administered by a provider.

Examples include:

   – Infusions in a provider’s office/outpatient setting
   – Medications that will be administered in a home setting
   – Injectables

To ensure timely processing of prior authorization requests, all supporting clinical information is required. Clinical information includes but is not limited to labs, radiology, clinical notes and utilization of previous medication for step therapy. For chemotherapy medication requests, include regimen and anticipated dates of service.

Lack of clinical information may result in delayed and/or denial of prior authorization request.

Contact Information

    – Prior Authorization Fax: 1-855-865-9469
    – Prior Authorization Phone: 1-800-460-8988

Contact Information

    – Prior Authorization Fax: 1-833-982-4001
    – Prior Authorization Phone: 1-866-399-0928


General Pharmacy Information

  • All opioids (excluding exemptions) will be limited to an initial seven (7) day supply.