Pharmacy

Lighthouse Health Plan covers a full range of prescription medications.  The Medicaid Preferred Drug List (PDL) is a list of covered medicines created following consideration and recommendations by the Florida Medicaid Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration.  Your doctor will use the PDL to choose the best medicine to treat you. Please ask your doctor or pharmacist if you have any questions about your medicines. Always ask the doctor if your prescription is covered by Lighthouse. If not, then ask the doctor to change it to a medicine that is covered. This will help you get your prescription filled the first time you take it to the pharmacy.

You do not have a co-payment for drugs we cover.

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 need to prior approve using a brand name drug before your prescription is filled.

Lighthouse also covers some non-prescription medications and items through our over-the-counter expanded benefit.

For Pharmacy Services call 1-844-253-1819

For Members


Getting Prescription Drugs

Lighthouse Health Plan’s list of participating doctors, hospitals, and pharmacies is growing every day.  If you are unable to find what you are looking for, please contact our Member Services at 1-844-243-5176 8am-8pm (ET)/7am-7pm (CT), Monday-Friday.

Find a Medication on the Florida Medicaid Preferred Drug List (PDL)

Search for an In-Network Pharmacy Near You

You may also order drugs through CVS using:

During the COVID-19 period, Lighthouse members may:

  • Get early refills of maintenance medications (excludes controlled substances).
  • Use mail order for maintenance medications without limits.
  • Request a 90-day supply of medications when the pharmacy has that amount.
  • Request a 90-day supply of medications by mail order.
Over-the-Counter Expanded Benefit

The Over-The-Counter (OTC) Benefit offers you an easy way to get generic OTC health and wellness products, like vitamins and first aid supplies, through CVS. You have a benefit of $25 per household per month.

Learn more about this benefit, find a CVS location, and order items online:

Lighthouse Over-the-Counter Health Solutions Website

A list of approved OTC items found in this catalog PDF:

Over-The-Counter Item Catalog 2020

Other Member Resources

Lighthouse Lock-In Program Description

Lighthouse Lock-In Change Request

Prescription Reimbursement Claim Form – English

Prescription Reimbursement Claim Form – Spanish

Diabetes Supply Formulary List

Drug Recalls

For Providers


If you are a provider looking for pharmacy and prior authorization information, please visit our:

Prior Authorizations Page

Provider Prior Authorization Request Line
Phone: 1-844-716-5412
TDD/TTY: 711
FAX: 1-866-265-5511

Additional Provider Resources

Preferred Drug List

Effective Immediately: June 2020 AHCA Preferred Drug List Changes, updated July 13, 2020

Summary of Drug Limitations

For Pharmacies


If you are a pharmacy that is already part of the Lighthouse Health Plan network and are looking for more information, please contact our Pharmacy Technical Help Desk at 1-800-364-6331.

Enroll as a Participating Pharmacy

If you are not a participating pharmacy provider within the CVS Caremark Networks, please follow the steps in the link below to initiate enrollment.

Enroll as a Participating Pharmacy

Additional Pharmacy Resources

Payor Sheet

EFT New Setup/Change Request Form

Mac Appeal Process

Mac Appeal Form