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Pharmacy Resources

Over the Counter (OTC)

To View the OTC FAQs (PDF)

To place an OTC order

For Members with Medicare coverage:

Please refer to your Medicare plan for more information on Prescription Drugs or call your FCC case manager if you have questions. Your Florida Community Care Case Manager can be reached at 1-833-FCC-PLAN or 711 for TDD/TTY.

For Members without Medicare coverage:

Getting My Medicine

If you are a member with no Medicare coverage, please click here for the Prescription Drug List for the Medicaid Managed Medical Assistance (MMA) Program.

FCC uses a Preferred Drug List (PDL). The PDL is a list of drugs that we prefer your doctor use. The Florida Medicaid PDL is subject to revision following consideration and recommendations by the Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration (AHCA). Medications on the PDL are organized by the therapeutic classification and includes brand and generic name along with any age limits and clinical prior authorization (PA) requirements. Please refer to the separate Summary of Limitations document for important information regarding quantity and/or age limits for applicable drugs.

We cover brand name and generic drugs. Generic drugs have the same ingredients as brand name drugs, but they are often cheaper than brand name drugs. They work the same. Sometimes, we may cover brand name drugs even if a generic is available.

The list of covered drugs may change from time to time, but we will let you know if anything changes. You can work with your doctor to ensure use of medications on the PDL or request prior authorizations for medications on the PDL with restrictions or not included on the PDL.

Your doctor will get prior approval for the drugs that need it. Your doctor may want to give you a drug that is not on the PDL. Your doctor will ask an approval through Florida Community Care’s Pharmacy Department. We will reply to your doctor in (24) hours. If the request is approved, we will tell your doctor. If a request is denied, a letter will be mailed. The letter will tell you the reason for the denial. The letter will let you know how to appeal.

You may be taking a drug that is no longer on our PDL. Your doctor can ask us to keep paying for this drug by requesting a prior approval. The drug must be safe and help you with your medical problem.

There are drugs that are not covered, for example some drugs for weight loss or cosmetic purposes. You may want to know the list of drugs that are covered. Call Enrollee Services at 1-833-FCC-PLAN or 711 for TDD/TTY.

You may call Enrollee Services to get the following: 

  • A copy of the Preferred Drug List
  • Information about drugs  
  • Find out if a drug is covered
  • Find out how to appeal a decision

Your doctor will work with Florida Community Care to decide which drugs are best for you.

Getting an exception to the Preferred Drug List (PDL)

Drugs not listed on the Preferred Drug List (PDL) are called non‐preferred drugs. For non‐preferred drugs, you have the following options:

  • You can ask your physician to order a similar drug that is listed on the Preferred Drug List (PDL).
  • You can ask your physician to request an exception so your non‐preferred drug can be covered by your benefit.
  • You can start the request for exception for a non‐preferred drug.
  • If you want to start the exception process, you can call Enrollee Services or your case manager at 1-833-FCC-PLAN or 711 for TDD/TTY

Over-the-Counter Benefit (OTC)

Florida Community Care offers a $25.00 over-the-counter (OTC) benefit every month for enrolled member. You can present your FCC ID card and the Over-the-Counter benefit list at an FCC contracted pharmacy. Please note that a generic product will be given, if on hand. To get more info, see the OTC Catalog or FAQs posted above or call our Enrollee Services Department at 1-833-FCC-PLAN or 711 for TDD/TTY.

Pharmacies

Florida Community Care has contracts with certain pharmacies. You must get your drugs at one of these pharmacies. Click Here to Find A Pharmacy closest to you. Make sure to bring your Plan ID card with you to the pharmacy.

Mail Service Pharmacy

Florida Community Care wants to offer a time-saving way to get select medicines. You can get a ninety (90)  day supply for certain medicines. This is a great benefit. It is easy and can save you time. You don’t have to go to the pharmacy every month. For more infomation, call the Enrollee Services Department. They can help you sign up.

Specialty Pharmacy Information

FCC covers a full range of specialty prescription medications. We have a list of drugs that we cover. This list is called the AHCA PDL. You can find this list here. You may also call Enrollee Services at 1-833-FCC-PLAN or 711 for TDD/TTY.

FCC wants to help you get great care. FCC will assign members to a specialty pharmacy if the member has use of a specialty medication. A list of specialty medications can be found by clicking the link below.

You can fill your first prescription at any network pharmacy. The assigned Specialty Pharmacy will arrange to have refills delivered to your place of residence or to a CVS pharmacy that you specify. FCC will send members utilizing a specialty medication a letter telling them how to contact their assigned specialty pharmacy. Members also have the option to opt-out of a specialty pharmacy assignment at any time.

Most assignments are for CVS Specialty Pharmacy. Residents in select locations will be assigned to JCR Medical Equipment & Pharmacy.

CVS Specialty Pharmacy specializes in medications that treat specific conditions. A CareTeam will assist with side effects, check dosage and medication schedules and help to answer all questions. They can give personalized counseling and answer questions about health and specialty medication, such as:

  • Tips on getting the most from medications
  • Advice on limiting and managing side effects
  • Dosage and administration checks
  • Changes to treatment plans
  • Safety tips and preparing for an emergency
  • The latest health news and information

If you have any questions about these services, please call CVS Specialty Pharmacy at 800-869-0479.

Smoking Cessation Information

Smoking Cessation Products are included in the AHCA PDL. These products can be obtained with a prescription from your Doctor. The smoking cessation products filled on a prescription will not count against your OTC benefit. No prior authorization is required. You may also call Enrollee Services at 1-833-FCC-PLAN or 711 for TDD/TTY.

HIV Drugs Information

HIV drugs are included in the AHCA PDL. These products can be obtained with a prescription from your Doctor. You can find this list on the State Web site. Prior authorization may be required. Your Doctor can request this.

Most HIV medications should be filled by a Specialty Pharmacy. See Specialty Pharmacy Information above.

You may also call Enrollee Services at 1-833-FCC-PLAN or 711 for TDD/TTY.

Contraceptive Drugs Information

Contraceptive drugs are included in the AHCA PDL. These products can be obtained with a prescription from your Doctor. No prior authorization is required.

You may also call Enrollee Services at 1-833-FCC-PLAN or 711 for TDD/TTY.

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