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.
Therapeutic Drug Interchange Lists
Sunshine Health has designed a pocket reference guide to help you quickly and easily select cost-effective drug alternatives that you determine may be appropriate for our members, your patients. We appreciate your partnership as we seek to improve health outcomes and lower costs when appropriate. As providers, you are best positioned to understand the needs of our members, your patients, but our Pharmacy Team is here to help. Reach us at 1-844-477-8313, ext. 41919 or SunshinePharmacy@centene.com.
Preferred Drug List
- Medicaid Preferred Drug List
- Medicaid Supplemental Preferred Drug List (PDF)
- 100-Day Supply List (PDF)
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
Prior Authorization Phone: (866) 399-0928
Prior Authorization Fax: (866) 399-0929