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Pharmacy and prescription drugs

We cover a wide range of prescription and over-the-counter (OTC) drugs. We work with IngenioRx to provide these pharmacy benefits.

Find a pharmacy

To find a pharmacy near you, use our pharmacy locator tool.

Find a pharmacy

Fill a prescription

Bring your or your child’s member ID and prescription to a plan pharmacy. A doctor can also call in the prescription for you.

It’s good to use the same pharmacy each time you fill a prescription. This way, your pharmacist will know about problems that may happen when you’re taking more than one prescription. If you use another pharmacy, you should tell the pharmacist about all medicines you or your child are taking.

Your costs

Copays are a set dollar amount you pay for a covered service, like getting a prescription filled.

Florida Medicaid members

There are no copays for covered prescriptions.

Florida Healthy Kids members

There is a $5 copay for covered prescriptions.

Have your medicines mailed to you

We make getting prescriptions filled as convenient as possible. You can log in to your account and manage your prescriptions filled through home delivery. With your secure online account, you can:

  • Order refills
  • Track your shipments
  • Get notifications
Log in to your account

Prescription Drug Home Delivery Form

You can get many prescription drugs shipped directly to your home through IngenioRx Home Delivery. Use this form to set up home delivery on your prescription.

Drug coverage information

Your benefits include a wide range of prescription drugs. Simply also covers many over-the-counter (OTC) medicines.

Florida Medicaid members

We use the Florida Medicaid Preferred Drug List (PDL). The PDL is the list of drugs that your doctor will use when prescribing medicine. Your doctor can prescribe most of these medicines to you without getting preapproval, or an “OK,” from us. The PDL is updated frequently.

View the Preferred Drug List

Don’t see it listed?

If you don’t see your medicine listed on the PDL, you may ask for an exception at submitmyexceptionreq@anthem.com. You’ll be asked to supply a reason why it should be covered, such as an allergic reaction to a drug, etc.

Extra over-the-counter (OTC) benefit

As a Simply Medicaid member, you get an extra benefit of $25 per family per month for over-the-counter medicines and supplies through our online store. You order from a list of approved OTC items and they are mailed directly to your home address. Log in to your secure account to place an order through the online drug store.

Visit online drug store

Florida Healthy Kids members

We have two drug lists that show which drugs are in your child’s plan.

Preferred Drug List (PDL)

The Preferred Drug List (PDL) is the list of drugs that your child’s doctor will use first when prescribing your child medicine. These drugs have been chosen for their quality and effectiveness. Your child’s doctor can prescribe most of these medicines without getting preapproval, or an “OK,” from us. The PDL is updated frequently.

You can also get many OTC medicines with a prescription from your doctor.

Don’t see it listed?

If you don’t see your child’s medicine listed on the PDL, you may ask for an exception at submitmyexceptionreq@anthem.com. You’ll be asked to supply a reason why it should be covered, such as an allergic reaction to a drug, etc.

Searchable formulary

The formulary is a list of all brand-name and generic drugs available in your child’s plan. It lists all the drugs found on the PDL, plus others. All drugs on the formulary are covered, but many require preapproval before the prescription can be filled.

Find their medicine

Do you want to look up your child’s medicine and find out if it is covered in their plan? It’s easy when you use our search tool. This tool will help you learn about any limitations or restrictions for any particular drug.

You can search for a drug by:

  • Typing the name (at least first three letters) of the drug in the search box
  • Using the A-Z list to search by the first letter of the drug
  • Clicking on the therapeutic class of the drug
Searchable Formulary

Extra over-the-counter (OTC) benefit

As a Simply member, your child gets an extra $10 per month for over-the-counter (OTC) items. Use this benefit at any pharmacy in our plan. Bring your child’s Simply member ID card to the pharmacy. Items on the OTC benefit list don’t need a prescription.

Prior authorizations (preapprovals)

Some medicines need a preapproval, or an “OK,” from Simply before your or your child’s doctor can prescribe them. The preapproval process helps us make sure that you’re taking medications safely and correctly.

Here are some reasons that preapproval may be needed:

  • There is a generic or pharmacy alternative drug available
  • The drug could be misused or abused
  • There are other drugs that should be tried first
  • The drug has a high side effect potential
  • The drug is prescribed at a higher dosage than recommended
  • There is additional information needed about your condition so we can match it to the FDA approval of the drug and/or studies of effectiveness

For medicines that need preapproval, your provider will need to call 1-877-577-9044.

Need help?

If you misplace your or your child’s medicine or it is stolen, contact your provider. They will work with the pharmacy and Simply to review your case and replace the medicines as needed.

If you have any questions about your or your child’s pharmacy benefit, call Pharmacy Member Services at 1-833-214-3607 (TTY 711) for Florida Medicaid or 1-833-267-3110 (TTY 711) for Florida Healthy Kids, 24 hours a day, 7 days a week.

Pharmacy forms

Prescription Drug Reimbursement Form

Florida Medicaid members do not pay copays for medications. Call Pharmacy Member Services at 1-833-214-3607 (TTY 711) before paying cash for a medication. If you had to pay for a medicine that is covered under your plan, you may submit a request for reimbursement form.

Prescription Drug Home Delivery Form

Get your specialty medications

If you or your child has a complex or chronic health condition that requires special medicine, we can help. We partner with IngenioRx Specialty Pharmacy and other pharmacies to meet all your specialty medication needs.

Learn about specialty pharmacy