Coordinated Care is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Coordinated Care members. Coordinated Care covers prescription medications and certain over-the-counter medications with a written order from a Coordinated Care provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.

Use our Medicaid Preferred Drug List to find more information on the drugs that are covered.

Prior Auth for Specialty Drugs

Please use the search function or select View All to locate the drug specific Coordinated Care prior authorization form that should be used when submitting an authorization request.

Pharmacy Maximum Allowance cost (MAC) Appeal

As of 5/1/2017, US Script MAC appeals are being managed by CVS Caremark®All US Script MAC appeals must be submitted using the MAC Appeal Form that can be accessed via the CVS Caremark Pharmacy Portal at

For instruction on how to submit MAC appeal using the CVS Caremark Pharmacy Portal, please click here.

Envolve Pharmacy Solutions, Coordinated Care's PBM, processes pharmacy claims and administers the medication prior authorization process.

Prior Authorization Fax: 1-866-399-0929
Prior Authorization Phone: 1-866-716-5099
Clinical Hours: Monday – Friday 7 a.m. - 5 p.m. (PST)
Help Desk: 1-877-250-6176

Telephonic Prior Authorization: 1-855-757-6565 (available 5 a.m. - 5 p.m. PST)

Coordinated Care  provides members with 90 day supplies through our preferred mail order pharmacy, Homescripts, or other participating retail maintenance drug pharmacies. The Maintenance Drug Program provides details of the products that can be dispensed as part of this benefit.

To transfer a current prescription or phone a prescription directly Homescripts call 1-800-785-4197.

Members can also obtain a 90 day supply (3 month supply) of their maintenance medications from participating retail maintenance drug pharmacies.

AcariaHealth, Coordinated Care's preferred specialty pharmacy vendor, can supply a number of products. Some of these products can be delivered directly to the provider’s location for office administration by Coordinated Care's preferred specially pharmacy provider, AcariaHealth.

For a complete listing of products that AcariaHealth can supply, please see the Coordinated Care Specialty Pharmacy Program (link to pdf).

Phone: 1-855-535-1815
Fax: 1-855-217-0926

Specialty Drug Request Forms

Non-Specific Specialty Prior Auth Form

To find a pharmacy that is in the Coordinated Care network, you can use the Find a Provider tool. Click on the Provider Directory then enter the city or zip code and click Update. Choose Other and type the name of the pharmacy or select the pharmacy type in the Select Specialty area. Only the network pharmacies are listed.