Pharmacy Information for Providers

Search for Covered Drugs

CCA covers a wide range of both over-the-counter, brand-name and generic prescription drugs at no cost to you. Find out if a medication is covered under your plan and what to do when it’s not.

CCA MassHealth Plans Coverage

CCA One Care (Medicare-Medicaid Plan) and CCA Senior Care Options (HMO D-SNP)

Find a Pharmacy

Outpatient Medications

Prior authorizations (PA) for certain drug prescriptions help ensure all necessary clinical criteria are met for coverage. The process for submitting a prior authorization may differ depending on several factors.

The main consideration is the medication:

• Type of medication.
• How the medication is administered.
• Where the medication is administered.

Coverage Determination

Please be advised, this form cannot be submitted for 2025 PA requests until December 1, 2024.

For some drugs, you will need to get approval (“prior authorization”) from Commonwealth Care Alliance 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.

Submit Prior Authorization Form Online

Prescriber Portal

The Prescriber Portal allows providers to access claim status, member eligibility, and claim submission options.

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