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Pharmacy Services

Children's Medical Services Health Plan (CMS Health Plan) covers prescription drugs detailed in the Florida Agency For Health Care Administration (AHCA) Medicaid Preferred Drug List (PDL).

The PDL is a list of covered medicines that we prefer you child’s doctor uses. Drugs the plan covers are on the PDL.

The doctor will use the PDL to choose the best medicine to treat your child. This list is reviewed by doctors and pharmacists regularly to make sure only the safest and most effective drugs are on the list. Please ask your child's doctor or pharmacist if you have any questions about medicines.

Always ask the doctor if a prescription is covered by Children’s Medical Services Health Plan. If not, then ask the doctor to change it to a medicine that is covered. This will help you get the prescription filled the first time you take it to the pharmacy.

Dispensing Limits

Medications may be dispensed up to a maximum of 34-day supply for each new prescription refill or 100-day supply for select medications. A total of 80% of the days’ supply must have elapsed before the prescription can be refilled at a network pharmacy.

Spacers for Inhalers – Children’s Medical Services (CMS) Health Plan

CMS covers select spacers/aerosol-holding chambers for members that will be covered through the pharmacy benefit. Members may receive one select spacer/chamber per year without prior authorization.

Covered Services

We cover brand name and generic drugs. Generic drugs have the same ingredients as brand name drugs. They work the same. Sometimes, we may need to approve using a brand name drug before your child’s prescription is filled.

13 and Under Requirements:

Some drugs for children 13 and under require a consent form (PDF).

  • A parent or legal guardian must complete and sign this form
  • The parent or legal guardian should fill out a separate form for each prescribed drug:
    • Medicaid will no longer pay for these drugs without the signed form 
    • You and your child's doctor will need to provide a copy of the form to the pharmacy when required

Have Questions?

Member Services can help answer any questions at 1-866-799-5321 (TTY 1-800-955-9770) Monday through Friday 8 a.m. to 8 p.m. Eastern. Your child's care manager can also help answer questions about services.


Get your prescriptions via mail-order

With this added benefit, you can have your child's medicines delivered to your home, at no cost. We offer pharmacy mail order through Express Scripts® Pharmacy. Your child can receive up to a 34-day supply on most medicines and up to a 100-day supply on some medicines (PDF)Some medicines are excluded (PDF).

How to Sign Up

  • Ask your doctor to electronically send or fax a new prescription to Express Scripts. Your doctor can fax Express Scripts at 1-800-837-0959. This number is for provider fax use only.
  • Register or sign in and have your member ID number ready. Follow the guided steps to request a prescription. Once Express Scripts has your information, they will contact your doctor for approval of your prescription.
  • Call Express Scripts at 1-833-750-4300 (TTY 1- 800-899-2114). Express Scripts can contact your doctor for a new prescription to be filled at mail order.
  • Mail a home delivery order form. To get a copy of the form, register or log in. Go to the Benefit Menu, click Forms, and download the Home Delivery Order Form. Complete the form and mail it with your paper prescription to Express Scripts.

Shop for over the counter items

You can now order over-the-counter health and wellness products through CVS. You can order online, by phone or in store


Preferred Diabetic Supplies

Effective September 1, 2021, OneTouch® is the only preferred brand of diabetes testing supplies for Children’s Medical Services Health Plan members. If your child is using OneTouch® meters for the first time, OneTouch Verio® offers different meter options to meet your child’s health needs. To support a smooth transition to the OneTouch Verio® meter, LifeScan is providing our members with a new meter at no cost to them. Call 1-833-239-0650 or visit

Read more details (PDF)