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Medication Information
Medical Drug Management (MDM)
Medicaid Prior Authorization List
To find out if prior authorization from Highmark Health Options is required for medical procedures and services, use the Prior Authorization Code Lookup.
Prescription Drug Coverage
*Highmark Health Options does not publish a MAC Pricing List as pharmacy reimbursement occurs in accordance with Delaware House Bill 219 which indicates the National Average Drug Acquisition Cost (NADAC) as the required reimbursement methodology. |
Prescriber Tools
Highmark Health Options requires prior authorization from HealthHelp for oncology medications. Submit prior authorizations in the Provider Portal via NaviNet.
Follow the instructions under the Prior Authorization with HealthHelp tab on the Provider Resources page.
FDA MedWatch Voluntary Safety Reporting
Health professionals, patients, and consumers can voluntarily report adverse events of human medical products. Adverse events may be suspected or observed, and they include problems or use/medication errors. Voluntary reporting helps bring to attention to unknown risks for FDA-approved medical products. Reporting can be done by phone, by fax, through the FDA MedWatch online reporting portal, or by downloading, completing, and submitting the FDA Form 3500 (Voluntary Reporting).
Prior Authorizations
Additional prior authorization requirements may apply. Refer to the Delaware Medicaid Preferred Drug List (PDL) for any additional prior authorization requirements.
Use the following General Drug Exception Form when none of the current prior authorization forms listed below apply: |
General Drug Exception Form for Prior Authorization | Updated April 2022 |
Medical and Pharmacy Prior Authorization Forms
Pharmacy-Only Prior Authorization Forms
Need more information?
If you can't find the information you need here, call Pharmacy Services at 1-844-325-6251.
