Pharmacy Prior Authorizations
The Pharmacy Services department at AmeriHealth Caritas Delaware issues prior authorizations to allow processing of prescription claims not listed on the Delaware Medical Assistance Program (DMAP) Preferred Drug List (PDL).
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 Therapies 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.
- HCPCS Coding List (PDF)