For commercial members enrolled in an AmeriHealth prescription drug program, prior authorization and quantity limit requirements will be applied to certain drugs. The purpose of prior authorization is to ensure that drugs are medically necessary and are being used appropriately. Quantity limits are designed to allow a sufficient supply of medication based upon the maximum daily dose and length of therapy approved by the U.S. Food and Drug Administration for a particular drug. The most recent updates are reflected below.

Drugs requiring prior authorization

The prior authorization requirement for the following non-formulary drugs was effective at the time the drugs became available in the marketplace:

Effective October 1, 2016, the following non-formulary drugs will be added to the list of drugs requiring prior authorization:

*Generic requires prior authorization.

Drugs with quantity limits

Quantity limits were/will be added or updated for the following drugs as of the date indicated below:

Drugs no longer requiring prior authorization

Effective September 1, 2016, the prior authorization requirement was removed for the following drugs:

For additional information on pharmacy policies and programs, visit our Pharmacy web pages for AmeriHealth New Jersey and AmeriHealth Pennsylvania.