Apple Health (Medicaid) drug coverage criteria
Use this page to find drug policies and request forms.
For information on billing and rates, the Apple Health preferred drug list, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates page.
Coverage for |
Policies and FAQs |
Forms |
---|---|---|
Androgenic Agents | ||
Antiasthmatic Monoclonal Antibodies | ||
Antibiotics | ||
Anticonvulsants | ||
Antidiabetics | ||
Antihyperlipidemics | ||
Atopic Dermatitis Agents | ||
Cardiovascular Agents | ||
Chronic GI Motility Agents |
||
Cytokine and CAM Agents | ||
Growth Hormone Agents | ||
Hepatitis C |
||
Medication Treatment for Substance Abuse Disorders (SUDs) |
||
Methadone | ||
Multiple Sclerosis Agents | ||
Opioids |
|
|
Ophthalmics | ||
Progesterones | ||
Proton Pump Inhibitors (PPIs) |
|
|
Pulmonary Arterial Hypertension (PAH) Agents | ||
Pulmonary Fibrosis Agents | ||
Spinraza |
|