Pharmacy information for providers
Search for Covered Drugs
CCA Health covers a wide range of both over-the-counter and brand-name and generic prescription drugs. Download the pdf document below to search our formulary and learn more about our covered drugs.
Download Our Covered Drugs List
Pharmacy Information
Coverage Determination
For some drugs, you will need to get approval (“prior authorization”) from CCA Health before we can agree to cover a drug for your patient. The requirement for getting approval in advance may also help to guide appropriate use of certain drugs. If you do not get this approval, your patient’s drug might not be covered by the plan.
Drug Prior Authorization Request Form
CCA Health Redetermination Form
If your request for coverage for a prescription drug was denied, you have the right to ask for an appeal of our decision.
Appeal Form for Drugs
Appeal Form for Drugs
Medication Transition Process
What can you do if a drug is not on the drug list or if the drug is restricted in some way?
If a drug is not on the drug list or is restricted, here are things you can do:
- Patients may be able to get a temporary supply of the drug (only members in certain situations can get a temporary supply). This will give you time to change to another drug or to file an exception
- You can change to another drug
- You can request an exception and ask the plan to cover the drug or remove restrictions from the drug
Read the document below to learn more.
Medication Transition Process
Drug Quality and Utilization Management
Special rules restrict how and when the plan covers certain drugs. A team of doctors and pharmacists developed these rules to help our members use drugs in the most effective ways. These special rules also help control overall drug costs, which keeps drug coverage more affordable. Read the document below to learn more.