Apple Health (Medicaid) drug coverage criteria
Use this page to find drug policies and request forms.
For information on billing and rates, the Apple Health preferred drug list, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates page.
| Coverage for | Policies | Policy Number |
|---|---|---|
| ADHD/anti-narcolepsy |
|
|
| Androgenic Agents |
|
|
| Anorexiants/Anti-Obesity |
|
|
| Antiasthmatic Monoclonal Antibodies |
|
|
| Antibiotics |
|
|
| Antidepressants |
|
|
| Antidiabetics |
|
|
| Antihemophilic |
|
|
| Antihyperlipidemics |
|
|
| Antiparasitics |
|
|
| Antipsychotics |
|
|
| Antivirals |
|
|
| Atopic Dermatitis Agents |
|
|
| Bone Density Regulators |
|
|
| Brands with Generic Equivalents |
|
|
| Cardiovascular Agents |
|
|
|
Chronic GI Motility Agents |
|
|
| COVID-19 |
|
|
| Corticosteroids |
|
|
| Cystic Fibrosis Agents |
|
|
| Cytokine and CAM Agents |
|
|
| Dermatologics |
|
|
| Endocrine and Metabolic Agents |
|
|
| Gout Agents |
|
|
| Growth Hormone Agents |
|
|
| Hormone replacement |
|
|
| Hematological Agents |
|
|
| Hematopoietic Agents |
|
|
| Immune Modulators |
|
|
| Migraine Products |
|
|
| Movement Disorder Agents |
|
|
| Musculoskeletal Therapy Agents |
|
|
| Neuromuscular Agents |
|
|
| Oncology |
|
|
| Opioids |
|
|
| Ophthalmics |
|
|
|
Proton Pump Inhibitors (PPIs) |
|
|
| Psychotherapeutic and Neurological Agents – MISC : Multiple Sclerosis Agents |
|
|
| Psychotherapeutic and Neurological Agents – MISC : Transthyretin Amyloidosis Agents |
|
|
| Pulmonary Arterial Hypertension (PAH) Agents |
|
|
| Pulmonary Fibrosis Agents |
|
|
| Respiratory Agents – MISC |
|
|
| Sleep Disorder Agents |
|