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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

  • 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
RXPCN: MCAIDADV
RXGRP: RX8775
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
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Last Updated On: 4/9/2019