Cenpatico Integrated Care (Cenpatico) covers prescription medication when:
- Your medication is on one of our preferred drug lists.
- You get your prescriptions filled at a network pharmacy.
- Your behavioral health medication prescriptions are written by an in-network behavioral health medical practitioner.
- You may be responsible for medication copayments.
It is important that you tell all your healthcare providers, including your dentist, about prescriptions you are already taking. Also, tell them about non-prescription medications, vitamins or herbal supplements you take.
Finding your medication(s) on the Drug Lists
- You can search by the drug name. The drug lists are arranged alphabetically (A-Z) by the drug name.
- The lists include drugs that are generally covered.
Cenpatico IC has two approved drug lists (formularies).
- Behavioral Health Drug List (BHDL) is ONLY for the following members:
- T19 General Mental Health/Substance Abuse persons (GMH/SA)
- Non-Title 19/21 persons determined to have a serious mental illness (SMI)
- T19/21 Child/Adolescent, T19/21 CMDP and all T19/21 DDD members
- Click here to view the Behavioral Health Preferred Drug List (BHDL). Behavioral Health Drug List by Name.
- Integrated Care Drug List is ONLY for the following members:
- Non DDD-T19/21 members determined to have a serious mental illness (SMI). Cenpatico IC fills your physical health and behavioral health medications.
- T19/21 SMI members with MEDICARE will have their physical health medications filled through the University of Arizona Health Network and their behavioral health medications filled through Cenpatico IC.
- Cenpatico IC may also cover your over-the-counter medications if they are on your approved-drug list. Like other medications, over-the-counter drugs must have a prescription from a provider to be covered at no cost to you.
- Click here to view the Integrated Care Drug List. Comprehensive Drug List by Name.
As a new or continuing member in our plan you may be taking drugs that are not on our drug lists. Or, you may be taking a drug that is on our drug list but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your provider.
How to get your prescriptions
If you need medicine, your provider chooses a medication from our list(s) of preferred drugs.
- Your provider writes a prescription for you. Ask your provider to make sure that the medicine is on one of the lists.
- Take the prescription to a network pharmacy to have it filled.
- If you only get behavioral health services from Cenpatico IC, you will not have an ID card. Your ID number is the same as your AHCCCS ID number. Ask your pharmacist to bill Cenpatico Integrated Care.
- If you have one, show your Cenpatico IC member ID card to the pharmacy staff.
- Enrolled members who paid cash for their medication(s) may be eligible for reimbursement. Please contact the Cenpatico Pharmacy Department at 866-495-6738 for details.
- If you paid for medications that qualify for a reimbursement, please complete the reimbursement form (English / Espanol) and fax to US Script as directed
How to find a network pharmacy
You can find a nearby network pharmacy by:
- Take the prescription to a network pharmacy to have it filled (see Find a Provider search tool above and select “Ancillary” for the provider type and “Pharmacy” for the Specialty) or Call Member Services at 866-495-6738 or 1 877 613-2079 (TDD/TTY). Ask the representative to help you find a network pharmacy in your area.
All prescriptions must be filled at a network pharmacy. Cenpatico IC does not cover prescriptions filled at other pharmacies.
Medications not on the approved drug lists
If your medicine is not on our approved-drug list(s), you can:
- Ask your provider for a similar drug that is on the list.
- Ask your provider to ask Cenpatico IC to cover your drug. Your provider will go through a prior authorization process. Your provider will know how to do this.
Over-the-counter (OTC) drugs
OTC drugs are non-prescription drugs that are not normally covered by a Medicare Prescription Drug Plan.
Your medicine bottle’s label says how many refills you can have. If you think you may need a refill, you must contact your provider at least five days before you run out of medicine. When you call, ask your provider about getting a refill. Your provider may want you to make an appointment before giving you a refill.
Medication Home Delivery
If you need medication home delivery services, please visit www.homescripts.com for information on receiving your medications at your home, workplace or doctor’s office.
Questions to ask about your medical practitioner
Cenpatico IC wants you to be as healthy as possible. This includes knowing about the different medicines you need to take. To help, we have included a list of questions you should always ask your provider about a prescription.
- Why am I taking this medicine? What is it supposed to do for me?
- How should the medicine be taken? When? For how any days?
- Are there any side effects or possible allergic reactions to this medicine?
- What should I do if I have a side effect or allergic reaction?
- What will happen if I don’t take this medicine?
Carefully read the drug information the pharmacy gives you with your medicine. It will tell you what you should and should not do while taking the medicine. If you have questions after you get your medicine, ask to speak with the pharmacist or call your provider.