Pharmacy benefits
Anthem Blue Cross and Blue Shield will administer pharmacy benefits for members enrolled in Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging. CarelonRx, Inc. is the pharmacy benefits manager. Please refer to the Preferred Drug List (PDL) when prescribing for these members.
Preferred Drug List (PDL) and formulary search
Statewide Uniform Preferred Drug List
Preferred Drug List
Formulary Search
Specialty Drug List
Benefit exclusions
Benefit exclusions are services not covered under the pharmacy benefit, which include medications:
- To treat infertility.
- To treat erectile dysfunction.
- For cosmetic reasons (Anti-wrinkle, hair removal, hair growth).
- Not approved by the FDA.
- That can be bought over the counter (unless specified on formulary or PDL).
To get pharmacy prior authorizations:
Don’t have an Availity account?
You can also request prior authorization by calling:
Hoosier Healthwise
1-866-408-6132
Healthy Indiana Plan
1-844-533-1995
Hoosier Care Connect
1-844-284-1798
Indiana PathWays for Aging
1-833-569-4739
Fax (Retail)
1-844-864-7860
Fax (MI)
1-888-209-7838
To find an in-network pharmacy
Use our Find a Doctor tool .
For inquiries, Chain and Pharmacy Services Administration Organization (PSAO) pharmacies can submit paid claim appeals through their respective chain or PSAO headquarters, which will then submit appropriate data to Caremark.
Independent pharmacies (those that are not affiliated with a PSAO for contracting purposes) can submit paid claim appeals using the Caremark Pharmacy Portal .
Related information
*CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield.
Page Last Updated: 07/12/2024