Pharmacy
Sunshine Health is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Sunshine Health members. Sunshine Health covers prescription medications and certain over-the-counter medications with a written order from a Sunshine Health 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.
Preferred Drug List
Prior Authorization Forms
- Prior Authorization Form – Non-Specialty Medication (PDF)
- Prior Authorization Form for Specialty Medication or Buy and Bill (PDF)
- Medication PA Criteria and Drug Specific Forms
- Compound over $300 Prior Authorization Request Form (PDF)
- Informed Consent For Psychotherapeutic Form (PDF)
- Hepatitis C Treatment Agreement (PDF)
- Antidepressant < 6 Years Prior Authorization Request Form (PDF)
- Antipsychotic (6 to < 18 Years of Age) Prior Authorization Request Form (PDF)
- Antipsychotic Less than 6 Years of Age Prior Authorization Request Form (PDF)
Additional Pharmacy Information
- Request to Change Lock-In Pharmacies (PDF)
- MPDS Lock-In Referral Form (PDF)
- Over-the-Counter Health and Wellness Catalog (PDF)
- Supplemental Preferred Diabetic Products (PDF)
RSV/Synagis Season
Preferred Drug List
Provider Educational Resources
Envolve Pharmacy Solutions provides quarterly educational outreach material to providers on common drug therapy and disease problems with the aim of improving prescribing and dispensing practices.