Texas Pharmacy Coverage | Ambetter from Superior HealthPlan

 

Pharmacy Resources

Ambetter from Superior HealthPlan is committed to providing appropriate, high quality, and cost effective drug therapy to all Ambetter from Superior HealthPlan members. Ambetter Health works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. Ambetter Health covers prescription medications and certain over-the-counter (OTC) medications when ordered by a practitioner. The pharmacy program does not cover all medications. Some medications require prior authorization (PA) or have limitations on age, dosage, and maximum quantities.

For more information about prior authorizations, visit Ambetter Health’s Pharmacy Program page.

Choosing a pharmacy

Ambetter Health has a variety of convenient in-network pharmacies. These include: HEB, CVS and Walmart, as well as many independent pharmacies in your area.

To find a network pharmacy near you, use our Find a Provider Tool and follow these steps:

  • Enter your zip code or address, or click Use my Current location.
  • Click Detailed Search and select Pharmacy from the Type of Provider drop-down menu.
  • If you are looking for a specific pharmacy like Home Infusion Therapy or Long Term Care, select that under the Specialty drop-down menu. Otherwise, you can skip this step.
  • If you need help finding a pharmacy, please call Member Services at 1-877-687-1196. Relay Texas/TTY users should call 1-800-735-2989.

More on Ambetter Health’s pharmacy program.

Use our Preferred Drug List (Formulary) to find more information on the drugs that Ambetter Health covers.

Forms

Save Money and Get Your Prescriptions Delivered to Your Door!

Prescription Delivery  

As an Ambetter Health member, you can maximize your pharmacy benefits by filling your prescriptions by mail. Eligible members may save when ordering a 90-day supply*. Delivery is free and can be to your home, workplace or any address you choose.  

Prescription delivery may be right for you if you take medications regularly for conditions like high blood pressure, arthritis or diabetes.  

Two easy ways to get started:  

  1. Call your provider and ask them to send a new 90-day prescription to Express Scripts® Pharmacy. 
  2. Or request prescription delivery in your online member account.

*Members may save when they fill eligible medications, 90 days at a time, through Express Scripts® Pharmacy.  

AcariaHealth

Looking for a specialty pharmacy to help navigate your complex or chronic condition? AcariaHealth is here to support you along your health care journey.

Get your specialty medications mailed directly to your door. AcariaHealth offers convenient specialty prescription delivery services for those living with complex conditions or chronic illnesses, such as rheumatoid arthritis, multiple sclerosis, hepatitis C, or cancer. AcariaHealth’s licensed pharmacists are also available to you 24/7 to discuss prescribed therapy and answer any questions regarding medications and supplies. Their team will work with your current specialty pharmacy provider to ensure a safe and seamless transition of your medications.

Learn more about how AcariaHealth can support you with your complex or chronic condition.

Hemophilia Network

Please refer to the link below for a comprehensive listing of Ambetter Health’s in-network hemophilia pharmacies.