Find a Provider, Pharmacy, or Drug

Discover the health care providers, pharmacies, and medicines covered by an AmeriHealth Caritas Next plan.

Find a health care provider

To find a provider for medical services, use our searchable online provider directory. 

Find a pharmacy

Retail pharmacy

We make it easy for you to find a pharmacy. Even when you travel out of state, you can find a pharmacy in our nationwide network by using our online pharmacy locator.

Mail-order pharmacy

If you want to have your prescriptions mailed to you instead of going to your local pharmacy, you can use our mail-order pharmacy. 

Note: Only prescribers may fax prescriptions to 1-800-491-7997. 

For retail pharmacy, mail-order pharmacy, and specialty pharmacy

You can use our online pharmacy locator for all of your in-network pharmacy needs, whether you need a local pharmacy, a pharmacy when you are traveling, a pharmacy to mail your prescriptions to your home, or a specialty pharmacy.

Find a drug

Our plans have a list of covered drugs (formulary). We call it the “drug list” for short. The drug list tells you how to find out which drugs are covered under your Health Insurance Marketplace plan. It also tells you if there are any rules that restrict coverage for your drugs.

There are two formulary tiers. If you have a Signature plan, the four-tier formulary applies to you. If you have any other plan, the six-tier formulary applies.

4-Tier Formulary Explanation (Signature plans)

  • Tier 1 — Preferred Generic Drugs
  • Tier 2 — Preferred Brand Drugs
  • Tier 3 — Non-Preferred Brand and Non-Preferred Generic Drugs
  • Tier 4 — Specialty Drug

6-Tier Formulary Explanation (all other plans)

  • Tier 1a — Preferred Generic Drugs
  • Tier 1b — Non-Preferred Generic Drugs
  • Tier 2 — Preferred Brand Drugs
  • Tier 3 — Non-Preferred Brand and Non-Preferred (High-Cost) Generic Drugs
  • Tier 4a — Specialty Drugs
  • Tier 4b — Non-Preferred Specialty Drugs

How to initiate an exception

For members

If you, or your authorized representative on your behalf, need a drug that is not covered by our formulary, you can submit a request for an exception. To submit a request, contact our Pharmacy Member Services department at 1-844-222-6439 (TTY 711) from 8 a.m. to 6 p.m. ET, Monday to Friday.

For providers

Please see information at  Pharmacy Prior Authorization.

Have questions?

Check out our Optum Rx Frequently Asked Questions (PDF), or call Pharmacy Member Services at 1-844-222-6439 (TTY 711).