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 Prior Authorization Criterion
How to submit a request for pharmacy prior authorizations
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.
- 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)
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.