Member Prescription Drugs

Your doctor may prescribe medication as part of your health care. It is important that you follow your doctor’s instructions and take the medication as your doctor has prescribed it.

You must have your prescription filled by a Health Choice Arizona participating pharmacy. Visit our Pharmacy Directory to search for a participating pharmacy in your area.

Health Choice Arizona provides a closed drug Formulary (medicine) benefit for its members. This means that if the drug is not in the Health Choice Formulary, Health Choice Arizona must first approve the prescription drug before you can purchase it at the pharmacy.

About the Health Choice Arizona Formulary

The Health Choice Arizona Formulary is your guide to prescription drugs covered by Health Choice Arizona. The Formulary is organized by sections. Each section includes therapeutic groups identified by either a drug class or disease state. Products are listed by generic name. Brand name products are included as a reference to assist in product recognition. Unless exceptions are noted, generally all dosage forms and strengths of the drug cited are covered. In addition, the Formulary covers selected over-the-counter (OTC) products.

Here is how you can view or search the Formulary:

To request a printed copy of our Formularies, call Member Services toll-free at 1-800-322-8670, Monday through Friday (except holidays), 6 a.m. – 6 p.m. TTY/TDD users can call 711.

Health Choice Arizona may add or remove drugs from our Formularies during the year. We will post Formulary updates here:

To get updated information about the drugs covered by Health Choice, call Member Services toll-free at 1-800-322-8670, Monday through Friday (except holidays), 6 a.m. – 6 p.m. TTY/TDD users can call 711.You may also contact us by e-mail at comments@HealthChoiceAZ.com

Brand Name vs. Generic Drugs

Health Choice Arizona covers both brand name and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug, but generic drugs usually cost less than brand name drugs. Generic drugs are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

Prescription Drug Restrictions and Limits

Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include:

Prior Authorization: Health Choice Arizona may require prior authorization for certain drugs. You will need to get approval from Health Choice Arizona for drugs noted with a “PA” in the drug list or for any drugs not listed in the formulary. If you do not get approval, Health Choice Arizona may not cover the cost of the drug.

Quantity Limits: For certain drugs, Health Choice Arizona may limit the amount of the drug that our plan will cover. For example, Health Choice Arizona provides 30 units per 30 days of Zolpidem.

You can ask Health Choice Arizona to make an exception to these restrictions or limits. For more information about prescription drug restrictions or limits, call Member Services toll-free at 1-800-322-8670, Monday through Friday (except holidays), 6 a.m. – 6 p.m. TTY/TDD users can call 711.