Texas Pharmacy Coverage | Ambetter from Superior HealthPlan

 

Pharmacy Resources

Ambetter takes our commitment to you seriously, and is honored to keep you covered during this unprecedented health situation.

For more details on COVID-19, Ambetter plan coverage, Telehealth, and prescription refills, please visit our FAQs page.

Ambetter from Superior HealthPlan is committed to providing appropriate, high quality, and cost effective drug therapy to all Ambetter from Superior HealthPlan members. Ambetter works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. Ambetter 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.

Choosing a pharmacy

Ambetter 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’s pharmacy program.

To find the cost of your medications please use our Drug Cost Tool.

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

Save Money and Get Your Prescriptions Delivered to Your Door!

Homescripts

As an Ambetter member, you can maximize your pharmacy benefits by filling your prescriptions with Homescripts, the only in-network mail order pharmacy. Eligible members pay only 2.5x* their regular copay for a three-month fill via Homescripts. Delivery is free and can be to your home, workplace or doctor’s office.

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

Enrolling is easy! Start today!

*2.5x copay is only applicable for three-month mail order fills from Homescripts. All other three-month mail order fills will be subject to the standard 3x copay.
 

AcariaHealth

Need a specialty pharmacy for your complex or chronic conditions? Prescription home delivery is available to you.

Get your specialty medications mailed directly to your door, free of charge. AcariaHealth offers 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.

AcariaHealth will work with your current specialty pharmacy provider to seamlessly transition your medications safely and efficiently. To get started, contact us at 1-800-511-5144.

Medication Adherence

Medication adherence is crucial in the management of chronic conditions such as elevated cholesterol, high blood pressure and diabetes. Taking your medications as directed by your Primary Care Provider (PCP) is key to your health and preventing serious consequences like a heart attack, stroke, or even an amputation.  Talk to your PCP or pharmacy about barriers to taking your medication.  Some tips to make it easier to manage your medication would include:

  • Speak with your PCP and/or pharmacy about lower cost medication choices
  • Request 90-day supplies of your medication from your PCP or pharmacy
  •  Sign up with a retail pharmacy’s auto-refill or refill reminder program
  •  Save trips to the pharmacy by having all of your medications filled at one time  
  •  Discuss with your pharmacy any delivery options available

If you need help getting your medications, contact the Ambetter from Superior HealthPlan Pharmacy Department at 1-800-218-7453, ext. 54019, from 8:00 a.m. – 6:00 p.m., Monday through Friday.