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Pharmacy benefits

PerformRx, an affiliate of AmeriHealth Caritas DC and a member of the AmeriHealth Caritas Family of Companies, is the delegated manager of pharmacy services covered by the AmeriHealth Caritas DC health plan. 

Important numbers

Pharmacy Provider Services

Medicaid - 1-888-602-3741
Alliance - 1-888-987-5821 

Pharmacy Member Services

Medicaid - 1-888-452-3647
Alliance - 1-888-987-5806

Pharmacy prior authorization fax

1-855-811-9332

Pharmacy TTY/TDD

1-888-989-0073

PerformSpecialty

PerformSpecialty is everything you expect from a specialty pharmacy and more. Our pharmacy was created specifically to meet the needs of AmeriHealth Caritas DC members and providers; everything we do is focused on delivering the highest quality of care to your patients. We offer:

  • 24/7 patient support
  • Patient support programs
  • Medication adherence programs
  • Complete pharmaceutical care management

For more information, visit PerformSpecialty or contact PerformSpecialty at 1-855-287-7888.

Important Information

Medicaid members
For more information on the provision of pharmacy services or to view the searchable and printable AmeriHealth Caritas DC drug formulary, please visit Medicaid drug formulary.

Alliance members
AmeriHealth Caritas DC Alliance program members have a distinct Alliance drug formulary and must use a participating Alliance program pharmacy. View the participating pharmacies list.

HIV/AIDS medicines
Medications used for the treatment of HIV/AIDS are managed directly by the District's Department of Health and must be filled at one of their participating ADAP/Alliance pharmacies regardless of plan participation. For more information, please call 1-202-671-4900.

Online prior authorization

Using our online Web submission tool, providers are able to:

  • Electronically submit all relevant member information.
  • Attach member-specific documents such as labs, chart notes, consults, etc.
  • Submit requests to PerformRx instantly.
  • Reduce prior authorization review time.
  • Obtain instant approvals for specific drugs.
  • Save unique provider information in order to expedite future Web submissions.
  • Print summary page for easy referencing.

Use our online pharmacy prior authorization request form. No login or password required.

Other important information

Transition supply

New members to the plan are eligible for a transition supply of non-formulary medications during their first 60 days of enrollment with the plan.

Over-the-counter medications

Certain generic over-the-counter medications are covered by AmeriHealth Caritas DC with a prescription from the prescribing physician and are limited to a 34-day supply. These include, but are not limited to, aspirin, acetaminophen, ibuprofen, cough and cold preparations, tobacco cessation products and antihistamines.

Whom to contact if you have questions:

  • Members can call our Pharmacy Member Services team at 1-888-452-3647 (TTY/TDD: 1-888-989-0073) if they need help or have questions.
  • Call PerformRx Pharmacy Services at 1-888-602-3741 to obtain the member's new ID number or if you have any questions or problems.