Carolina Complete Health covers most prescription medications. Some prescriptions require prior authorization and may have limitations based on age or the amount of medicine prescribed. Carolina Complete Health also covers certain over-the-counter medications with a prescription from a Carolina Complete Health provider.
Carolina Complete Health covers certain prescription drugs and over-the-counter drugs when prescribed by an Carolina Complete Health provider. The pharmacy program does not cover all drugs. Some drugs require prior authorization and may have limitations on age, dosage or maximum quantities.
The Preferred Drug List (PDL) is a list of drugs covered by Carolina Complete Health. Carolina Complete Health works with the State of North Carolina to ensure that medications used to treat a variety of conditions and diseases are covered. The PDL applies to drugs you receive at retail or mail order pharmacies. Carolina Complete Health's PDL is continually evaluated by Pharmacy and Therapeutics Committees to promote the appropriate and cost-effective use of medications.
To view the Preferred Drug List, visit the Manuals and Forms page.
Pharmacy Clinical Coverage Criteria (Coming soon)
Prior Authorization Request Forms (Coming soon)