Pharmacy Information
Anthem Blue Cross and Blue Shield Medicaid (Anthem) will administer pharmacy benefits for enrolled members. MedImpact is the pharmacy benefits manager.
Medicaid Preferred Drug List (Formulary)
MedImpact, in conjunction with the Commonwealth of Kentucky, manages a list of drugs providers can choose from called a Preferred Drug List (PDL). The PDL includes all medications covered by Medicaid, including some over-the-counter drugs.
Providers may need to get approval from MedImpact for certain drugs. This is known as prior authorization. The request should include why a specific drug is needed and how much is needed. If prior authorization is required, providers must get approval from MedImpact before a prescription can be filled. There may be some physician administered medical injectable drugs that require approval from Anthem before a prescription can be filled.
Pharmacy prior authorization requests
To submit electronic prior authorization (ePA) requests online, use Availity .
Prior authorization phone and fax numbers
All prior authorizations will be managed by MedImpact. Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review.
Hours: Monday to Friday from 8 a.m. to 7 p.m. Eastern time
Prior authorization
Phone:
1-844-336-2676
Prior authorization for medical injectables
To submit electronic prior authorization (ePA) requests online, use Availity .
Fax:
1-844-487-9289
Prior authorization forms for pharmacy services can be found on the Forms page.
Prior authorization for retail pharmacy
Fax:
1-858-357-2612
Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.