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Pharmacy services

Pharmacies are where you pick up your medicines (drugs). If your doctor gives you a prescription, you must go to a pharmacy in AmeriHealth Caritas Louisiana's network.

Find an AmeriHealth Caritas Louisiana pharmacy

To find a pharmacy, view our pharmacy directory. You can also get a hard copy of the AmeriHealth Caritas Louisiana participating pharmacy directory by calling Pharmacy Member Services at 1-866-452-1040.

Approved medicines

The drug formulary is the list of medicines AmeriHealth Caritas Louisiana covers. This list helps your doctor prescribe medicines for you.

See the AmeriHealth Caritas Louisiana drug formulary.

Brand name and generic medicines are on the drug formulary. AmeriHealth Caritas Louisiana requires that generic medicines be used when available.

If a certain medicine is not listed on the drug formulary, your doctor may ask for it through AmeriHealth Caritas Louisiana's prior authorization (pre-approval) process.

Prescriptions

Your doctor will write a prescription for medicine and over-the-counter drugs when you need it. AmeriHealth Caritas Louisiana covers medicines that:

  • Are medically necessary
  • The Food and Drug Administration (FDA) approves
  • Are not excluded by the Louisiana Medicaid program, and
  • A doctor prescribes

To get a prescription filled:

  • Pick a pharmacy that is part of the AmeriHealth Caritas Louisiana network and is close to your work or home.
  • Take your prescription to the pharmacy. Give it to the pharmacist along with your AmeriHealth Caritas Louisiana Member ID Card , DHH ID card and any other health insurance card(s) you have.

If you are out of town and you have an emergency or need urgent care and need a prescription filled, call Pharmacy Member Services at 1-866-452-1040.

Copays

Some adult members will need to pay a small copay for their prescriptions. The copays for medication are as follows.

Copay calculated state payment:

  • $0.50 for $10.00 or less
  • $1.00 for $10.01 to $25.00
  • $2.00 for $25.01 to $50.00
  • $3.00 for $50.01 or more

There will be no copay for members who are:

  • Less than 21 years of age
  • Pregnant
  • Receiving emergency services
  • Federally recognized Native Americans or Alaska Native
  • In long-term care facilities

Prior authorization (pre-approval)

Your doctor may write a prescription for a medicine that is not on the AmeriHealth Caritas Louisiana drug formulary. Your doctor will need to send us a prior authorization request form (PDF). We will review and let your doctor know our decision.

If AmeriHealth Caritas Louisiana does not approve the medicine, you will get a letter that will tell you why. The letter will tell you how to make an appeal if you want to do so.

Continuity of care (transition supply)

AmeriHealth Caritas Louisiana will provide a supply of the non-formulary prescription medicines in the following categories for at least 60 days after you become an AmeriHealth Caritas Lousiana member:

  • Medications you take regularly for chronic conditions (maintenance medicines)
  • Antidepressant and antipsychotic medicines
  • Medication you are prescribed in a state mental health treatment facility as long as the medication is medically necessary and not harmful to you.

Family planning services

AmeriHealth Caritas Louisiana covers family planning supplies provided through a participating pharmacy. There are no co-pays for these supplies, such as birth control medications.

Pharmacy member services

If you have questions, please call the Pharmacy Member Services toll-free at 1-866-452-1040. TTY users, call 1-855-294-7047.

New members

  • If you don't yet have an ID card when you go to fill your prescription, tell the pharmacy to call Pharmacy Provider Services at 1-800-684-5502. We will look up your member ID number and share it with your pharmacy.
  • Call our Pharmacy Member Services team at 1-866-452-1040 (TTY 1-855-294-7047) if you need help or have questions.
Do more online. Don't wait until you run out. Get automatic refill reminders in the member portal.