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.

• Search a Drug

Printed Preferred Drug Lists

• New Jersey Medicaid Preferred Drug List (PDF)
• New Jersey Medicaid Machine Readable File 
• New Jersey Supplemental Preferred Drug List (PDF)
• New Jersey Notice of Change (PDF)