Pharmacy Prior Authorizations
The Pharmacy Services department at AmeriHealth Caritas Delaware issues prior authorization to allow processing of prescription claims that are non-preferred, have clinical criterion, or are not listed on the Delaware Medical Assistance Program (DMAP) Preferred Drug List (PDL).
AmeriHealth Caritas Delaware Prior Authorization Criterion
Prior Authorization Criterion (PDF)
How to submit a request for pharmacy prior authorizations
Online
To submit electronically, please submit an Electronic Prior Authorization (ePA) through your Electronic Health Record (EHR) tool software, or you can submit through any of the following online portals:
By phone
Call 1-855-251-0966, 8:30 a.m. to 7 p.m., Monday through Friday.
After business hours, Saturday, Sunday and holidays, call Member Services at 1-877-759-6257.
By fax
- Fax your completed prior authorization request form to 1-855-829-2872.
- ADHD Medication Form (PDF)
- Benzodiazepine Quantity Limit Form (PDF)
- Biological Medication Form (PDF)
- HCPCS Drug Authorization Form (PDF)
- Hepatitis C Non-preferred and Quantity Limit Form (PDF)
- Injectable/Infusible Medications Form (PDF)
- Opioid Products Form (PDF)
- Universal Pharmacy Form (PDF)
Emergency supply
In the event a member needs to begin therapy with a non-covered medication before you can obtain prior authorization, pharmacies are authorized to dispense up to a 72-hour emergency supply.