Pharmacy
It's important to SilverSummit Healthplan 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.
Nevada Medicaid Member Preferred Drug List (PDL and Clinical Documents)
Drug Look-up Tool
SilverSummit Healthplan covers certain prescription drugs and over-the-counter drugs when prescribed by a SilverSummit Healthplan provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage or maximum quantities.
The Preferred Drug List (PDL) is the list of drugs covered by SilverSummit Healthplan. SilverSummit Healthplan 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 or mail order. SilverSummit Healthplan's PDL is continually evaluated by the Pharmacy and Therapeutics Committee to promote the appropriate and cost-effective use of medications.
As a commitment to our members’ overall health and wellbeing, at SilverSummit Healthplan we offer an additional quarterly benefit of $30 per member household, for commonly-used over-the-counter (OTC) items not covered through SilverSummit’s Prescription Plan.
- Members may select from any items up to the $30 per quarter limit
- Items on the list include, but are not limited to: cough/cold/allergy medicines, antacids, and oral care.
- Medication and products cannot be returned once they are received by the member.
- If the order is undeliverable or unavailable, members are provided a full return or replacement order.
- Remaining balances are NOT carried over to the next quarter.
Please have your SilverSummit ID and Medicaid ID available when you call. When ordering, please have the item number ready.
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.
Your specialty pharmacy is AcariaHealth. They can be reached at 1-800-511-5144.
You can have your prescriptions filled at a network pharmacy. At the pharmacy, you will need to give the pharmacist your prescription and your SilverSummit Healthplan ID Card. If you need help finding a pharmacy near you, call us or check online.
To find a pharmacy that is in the SilverSummit Healthplan network, you can use the Find a Provider tool.
- Type in your city or zip code. C
- Click Update.
- Choose Other
- Type the name of your pharmacy.
You can also select the pharmacy type in the Select Specialty area. Only those pharmacies in the SilverSummit Healthplan network are listed.