Pharmacy
Fidelis Care is committed to working with providers to improve members' health and well-being. The following information will help your patients get the most out of their pharmacy benefits.
Coverage Determination
The Coverage Determination process enables providers to request an addition or exception.
Medication Appeals
Providers may appeal a coverage determination decision by contacting our Pharmacy Appeals department via fax, mail, in person or phone. Please refer to the Quick Reference Guide for instructions.
- Online: Request Appeal for Drug Coverage using our online form
- Fax or Mail: Complete an Appeal of Coverage Determination Request (PDF)
Preferred Drug List (PDL)
The Preferred Drug List contains information about drugs covered by the plan. Please check back for updates, as PDLs are periodically amended. Search for a drug using our online tool, or view or print the PDL.
Printed Preferred Drug Lists
Other Helpful Information
AcariaHealth Specialty Pharmacy offers expert service in the special handling, storage and administration of medications for Fidelis Care members who have long-term, life-threatening or rare conditions. With its knowledge of the insurance process and plan benefits, the team can speedily help the patient receive his or her medication. For a detailed list of conditions covered, please visit our AcariaHealth Specialty Pharmacy page.