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To obtain authorization for a nonpreferred drug, a client must have tried and failed, or is intolerant to, a designated number of preferred drugs within the drug class unless contraindicated or not clinically appropriate. In addition to approval criteria for nonpreferred products, some drugs have additional criteria that must be met. Note: For continuity of care, all plans will use the same PA criteria, step therapy edits, and quantity limits developed by HCA.

If you can't find the versions you're looking for, email us applehealthpharmacypolicy hca. Note: For information on billing and rates, the Apple Health PDL, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates webpage. See what drugs are preferred and whether they need a prior authorization PA. How to use the Apple Health PDL Preferred drugs within a chosen therapeutic class are selected based on clinical evidence of safety, efficacy, and effectiveness.

Related forms and publications Emergency fill policy. Related links Request a pharmacy prior authorization Barcoded document submission cover sheets Apple Health Medicaid drug coverage criteria Implementation status reports under Agency reports.

How do I get dental care? A specialty drug is a prescription drug that requires special handling, administration, or monitoring.

These are usually only ordered through a specialty pharmacy. If you are unsure whether your current medication is a specialty drug, please review our Specialty Pharmacy Program. It has a list of specialty drugs, plus more information about them. You can have your prescriptions filled at a pharmacy in the Iowa Total Care network. If you need help finding a pharmacy near you, call us at TYY: As a general rule, Iowa Total Care members are allowed day supply with the exception of birth control. Iowa Total Care members are allowed a 3 month supply of birth control.

You can also select the pharmacy type in the Select Specialty area. Only those pharmacies in the Iowa Total Care network are listed. Be Well. Eat Well. Iowa Total Care Literacy Program.

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You can also use your catalog to view eligible products. You have three easy ways to shop: online, in-store at a participating store location, or over the phone. Best of all, all shipping costs are waived for members and will not be deducted from your benefit balance.

They are fully covered by your health plan at checkout. Skip to main content. Plus, you may be eligible for additional benefits on either Assistive Devices or Service Dog Support items. How It Works. You can use your benefits to purchase OTC items including allergy medication, cough drops, first aid supplies, oral care, pain relievers, vitamins and more!

With Assistive Devices, you can use your benefits to purchase grab bars, bath chairs, hand showers, hearing amplifiers, low vision aids, dressing aids, portable ramps and more! With Service Dog Support, you can use your benefits to purchase dog food, feeding supplements, bowls, dog brushes, harnesses, leashes, training pads and more!

Order online To order online, you can explore thousands of approved over-the-counter health products on the website or mobile app.

After browsing, click Buy Online and you will be automatically transferred to Walmart. If you don't have a Walmart. When you're ready to checkout, select the Gift Card option for payment and enter your digit account number and 4-digit security code that's on the back of your OTC card. You may notice a delivery charge in email correspondence from Walmart under your Order Summary but rest assured, all shipping costs are waived for members. Plus, you may be eligible for additional benefits on either Assistive Devices or Service Dog Support items.

How It Works. You can use your benefits to purchase OTC items including allergy medication, cough drops, first aid supplies, oral care, pain relievers, vitamins and more! With Assistive Devices, you can use your benefits to purchase grab bars, bath chairs, hand showers, hearing amplifiers, low vision aids, dressing aids, portable ramps and more!

With Service Dog Support, you can use your benefits to purchase dog food, feeding supplements, bowls, dog brushes, harnesses, leashes, training pads and more!

Order online To order online, you can explore thousands of approved over-the-counter health products on the website or mobile app. After browsing, click Buy Online and you will be automatically transferred to Walmart. If you don't have a Walmart. When you're ready to checkout, select the Gift Card option for payment and enter your digit account number and 4-digit security code that's on the back of your OTC card.

You may notice a delivery charge in email correspondence from Walmart under your Order Summary but rest assured, all shipping costs are waived for members.

You can also pre-shop in your catalog. Make note of product names and sizes. Then head to the participating store of your choice. If you have questions about item eligibility while in store, you can use the mobile app scanner. To checkout, simply scan your card or mobile app barcode at checkout to instantly redeem your benefits.