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Maryland Medicaid Formulary

The medications included in the Amerigroup formulary are reviewed and approved by the Amerigroup Pharmacy and Therapeutics Committee, which includes Practitioners and Pharmacists from the Amerigroup Provider community.

Medications not listed in the formulary are considered to be non-formulary and are subject to prior authorization.

Some medications listed may have additional requirements or limitations of coverage. These requirements and limits may include prior authorization, quantity limits, age limits or step therapy.

Additionally, if a medication is available as a generic formulation, this will be Amerigroup's preferred agent, unless otherwise noted. If you have any questions about coverage of a certain product, please contact us at 800-454-3730.


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Formulary Id: 00000000
Formulary Effective Date: 03/16/2015
Updated:
11/2017
CMS Approval Date:
09/25/2017

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