Pharmacy benefits

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

• Healthy DC Plan Drug Formulary
• Prior authorization criteria (PDF)

Important Information

• Pharmacy prior authorization forms

Using our online submission tool, providers are able to:

• Electronically submit all relevant enrollee information.
• Attach enrollee-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.

Important numbers

Specialty pharmacy

PerformSpecialty is everything you expect from a specialty pharmacy and more. Our pharmacy was created specifically to meet the needs of AmeriHealth Caritas DC enrollees 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.

We partner with several other specialty pharmacies for limited distribution medications based on the needs of our enrollees.

Other important information

Transition supply

New enrollees 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

Select over-the-counter products are available with a prescription from the prescribing physician, for example, diabetic testing supplies.

Whom to contact if you have questions:

• Enrollees can call our Pharmacy Enrollee Services team at 1-844-214-2474 (TTY 711) if they need help or have questions.
• Call PerformRx Pharmacy Services at 1-888-369-0247 to obtain the enrollee's new ID number or if you have any questions or problems.