Pharmacy
It’s important to Peach State Health Plan that our members receive drug therapy that is appropriate, high quality and cost effective. We work hard to ensure you have access to safe and effective medications that are medically proven to help you get healthy and stay healthy.
WHAT PHARMACY BENEFITS ARE OFFERED?
Peach State Health Plan covers certain prescription drugs and over-the-counter drugs when prescribed by a Peach State Health Plan provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage or maximum quantities.
WHICH DRUGS ARE COVERED?
The Preferred Drug List (PDL) is the list of drugs covered by Peach State Health Plan. Peach State Health Plan works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. The PDL applies to drugs you receive at retail pharmacies. The Peach State Health Plan PDL is continually evaluated by the Pharmacy and Therapeutics Committee to promote the appropriate and cost-effective use of medications.
Preferred Drug List (PDL) Look-Up Tools
- Georgia Families® & PeachCare for Kids® PDL Look-Up
- Planning for Healthy Babies®: Family Planning PDL Look-Up
- Planning for Healthy Babies®: Inter-Pregnancy Care PDL Look-Up
PDL References
- Georgia Families® & PeachCare for Kids® Preferred Drug List (PDL) (PDF)
- Planning for Healthy Babies®: Family Planning Preferred Drug List (PDL) (PDF)
- Planning for Healthy Babies®: Inter-Pregnancy Care Preferred Drug List (PDL)(PDF)
- PDL Updates (effective 12/25/2024)(PDF)
- PDL Updates (effective 09/23/2024)(PDF)
- PDL Updates (effective 06/24/2024)(PDF)
- PDL Updates (effective 03/25/2024)(PDF)
- PDL Updates (effective 12/18/2023) (PDF).
- PDL Updates (effective 09/25/2023) (PDF).
- PDL Updates (effective 06/26/2023) (PDF).
- PDL Updates (effective 03/27/2023) (PDF).
- PDL Updates (effective 09/19/2022) (PDF).
- PDL Updates (effective 12/19/2022) (PDF).
How to search the Preferred Drug List
- Open the Preferred Drug List
- Press Ctrl F to open the search tool
- Type in the drug name into the text box
- Press enter
You or your provider can use this form to request a review if your medicine needs to have authorization - Pharmacy Medication Request Form (PDF)
HOW DO I GET MY MEDICATIONS?
You can have your prescriptions filled at a network pharmacy. At the pharmacy, you will need to give the pharmacist your prescription and your Peach State Health Plan ID Card. If you need help finding a pharmacy near you, call us at 1-800-704-1484 (TTY/TDD 1-800-255-0056).
WHERE CAN I GET MY PRESCRIPTION FILLED?
To find a pharmacy that is in the Peach State Health Plan network, you can use the Find a Provider tool. Type in your city or zip code. Then click Update. Choose Other and type the name of your pharmacy. You can also select the pharmacy type in the Select Specialty area. Only those pharmacies in the Peach State Health Plan network are list.