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SilverSummit Healthplan is committed to providing appropriate, high-quality, and cost-effective drug therapy to all SilverSummit Healthplan members. SilverSummit Healthplan covers prescription medications and certain over-the-counter medications with a written order from a SilverSummit Healthplan provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.

Drug Look-up Tool

Search the list of FDA-approved drugs and coverage by clicking the button below.

Search Now

Prior Auth Forms

Please use the search function or select View All to locate the drug specific SilverSummit Healthplan prior authorization form that should be used when submitting an authorization request.

Electronic Prior Authorization Submissions

Electronic Prior Authorization Submissions
Submit your prior authorization (PA) requests electronically through our preferred solution CoverMyMeds. Electronic prior authorization (ePA) automates the PA process making it a quick and simple way to complete PA requests. The ePA process is HIPAA compliant and enables faster determinations. You may also use this link to track ePA requests.

Submit PA Request

Centene Pharmacy Services

Appropriate Use & Safety Edits (PDF)

SilverSummit Healthplan's PBM, processes pharmacy claims and administers the medication prior authorization process.

Prior Authorization Fax: 1-866-399-0929

Clinical Hours: Monday – Friday 10 a.m. - 8 p.m. (EST) 

The Maintenance Drug Program provides details of the products that can be dispensed as part of this benefit.

Members can also obtain a 100 day supply (3 month supply) of their maintenance medications from participating retail maintenance drug pharmacies.

Maintenance Medications Up to 100 Days (PDF)

To find a pharmacy that is in the SilverSummit Healthplan network, you can use the Find a Provider tool.

AcariaHealth, SilverSummit Healthplan's preferred specialty pharmacy vendor, can supply a number of products. Some of these products can be delivered directly to the provider’s location for office administration by SilverSummit Healthplan's preferred specially pharmacy provider, AcariaHealth.

AcariaHealth -
Phone: 1-800-511-5144

Prior Authorization Request Form For Specialty Prescription Medications (PDF)