Pharmacy
As part of our dedication to members, AmeriHealth Caritas North Carolina works with providers and pharmacies across the state to help ensure those who need care have convenient and reliable access to effective health care services.
Use the resources below to assist with member prescriptions and other pharmacy services.
Pharmacy benefits
- Member pharmacy benefits
See which services and drugs AmeriHealth Caritas North Carolina covers for our members.
Prior authorization
- Pharmacy prior authorization
Pharmacy services requiring prior authorization - Prior authorization
Prior authorization look-up tool and service-specific guidance
Pharmacy resources
- Pharmacy Clinical Coverage Policies Opens a new window
- Find a pharmacy Opens a new window
Use our online directory to search for an in-network pharmacy near you. - AmeriHealth Caritas North Carolina Medication Look-Up Tool Opens a new window.
Use the Medication Look-Up Tool to search for covered medicines.- Preferred Drug List (PDL) Opens a new window
Prescribers are encouraged to write prescriptions for preferred products but may prescribe medications that are not on the PDL. - Biosimilar PDL Updates
A quick reference for the preferred biosimilars and interchangeable biosimilars medications listed on the NC Medicaid PDL - If a prescriber deems that the patient's clinical status necessitates therapy with a non-preferred drug, the prescriber will be responsible for initiating a prior authorization request.
- Preferred Drug List (PDL) Opens a new window
- Pharmacy Lock-in Program
Our lock-in program assigns members to a specific pharmacy and prescriber provider. - Over-the-counter medications and products
AmeriHealth Caritas North Carolina covers certain over-the-counter medications and products. Find out more. - Pharmacy prior authorization
Pharmacy services requiring prior authorization - Pharmacy copays
Some members may be responsible for copays for brand prescriptions.
Contact pharmacy services
AmeriHealth Caritas North Carolina provides pharmacy services through our pharmacy benefits manager (PBM) PerformRxSM. For pharmacy contracting questions and assistance, call PerformRx Contract Services at 1-800-555-5690.
PerformRx North Carolina Member Services:
1-855-375-8811 (TTY 1-866-209-6421)
PerformRx North Carolina Provider Services:
1-866-885-1406
PerformRx:
TTY 1-855-809-9206