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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.

Drug Lists

General Pharmacy Forms

Prior Authorization 

Drug Lists

General Pharmacy Forms

Prior Authorization 

Preferred Drug List

Prior Authorization Forms

Additional Pharmacy Information

CVS Retail Pharmacies No Longer in network for 2022

Ambetter from Sunshine Health wants to make sure that our members receive the highest quality care at the lowest premium. One way we do this is by monitoring our pharmacy network performance.

To provide our members, your patients with the lowest possible premium for 2022, CVS retail pharmacies will no longer participate in our network as of January 1, 2022.

Additionally, Walgreens retail pharmacies will be the only in-network pharmacy for extended days’ supply prescriptions (those for 84 or more day supply). Members pay only 2.5 copays (save ½ a copay) when they fill eligible maintenance medications, 90 days at a time, at Walgreens starting January 1, 2022.

If your patients currently fill their prescriptions at CVS retail pharmacies, please send or call in their scripts to any in-network pharmacy. To help you locate an alternate in-network pharmacy for 2022, please refer to the Ambetter Health Guide Website.

We value having you as an Ambetter from Sunshine Health provider and we hope this information allows you to make informed decisions about managing your patient’s health.

Long Acting Injectable Antipsychotics (LAIAs) Administration Sites

Pharmacies with staff authorized to administer Long-Acting Injectable Antipsychotics (LAIAs) are available. Please contact the pharmacy for location-specific requirements.