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Children's Medical Services Health Plan

Children’s Medical Services Health Plan (CMS Health Plan) covers prescription drugs as provided for in the Florida Agency for Health Care Administration (AHCA) Medicaid Preferred Drug List (PDL).

Drug Evaluation Request Forms


  • Prescriptions must be picked up at a pharmacy that is part of the plan network (A list of such pharmacies is in the provider directory)
  • Prescription drugs the plan covers are on the PDL (Doctors, pharmacists and nurses make this list)
  • Pharmacies may submit claims to the Florida Children's Medical Services Health Plan using the following information:
RXBIN: 004336
Member ID Format: 10 digits, numeric
Person Code: Not required

13 and Under Requirements:

Some drugs for children 13 and under require a consent form.

  • A parent or legal guardian must complete and sign this form 
  • The parent or legal guardian should fill out a separate form for each prescribed drug
    • Medicaid will no longer pay for these drugs without the signed form
    • You and the member will need to be able to provide a copy of the form to the pharmacy when it is required

Helpful Documents

PDL Update

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Last Updated On: 12/4/2020
Medicare Members: Your materials are on the way! We realize you may be waiting to receive some plan materials and we apologize for any delays. Did you know you can go online to our member portal to view Member materials, review your benefits, request or download an ID card, or choose a physician (when applicable)? Log in or register today!