Pharmacy

Provider Pharmacy Prior Authorization Forms are located on the Provider Resources Forms page, under Prior Authorization Forms.

Superior HealthPlan is committed to providing appropriate, high-quality and cost-effective drug therapy to all members. Superior covers prescription medications as outlined by the Texas Medicaid and CHIP Vendor Drug Program (VDP).  Some medications may require prior authorization, and may have clinical prior authorization edits or other limitations consistent with FDA recommendation for safe and effective use. Other medically necessary pharmacy services or products are covered as well and consistent with the Vendor Drug Program. 

Pharmacies wishing to be contracted as a provider are required to be a Medicaid provider and be contracted with Superior’s Pharmacy Benefit Manager (PBM). Pharmacies should contact the contracted PBM and the Vendor Drug Program directly for contracting assistance.

For prior authorization of medications within the Vendor Drug program contact the PBM at 1-800-460-8988.

For information regarding contracting as a network pharmacy, please visit https://pharmacy.envolvehealth.com/contact.html.

To access to the Texas Medicaid/CHIP Vendor Drug Program (VDP), including the Medicaid formulary and Preferred Drug List (PDL), visit https://hhs.texas.gov/services/health/medicaid-chip. The VDP link is under Resources for Providers.

Medicaid/CHIP Pharmacy Help Desk
Toll Free: 1-866-768-0468

Prior Auth Requests
Phone: 1-866-399-0928
Fax: 1-866-399-0929

Medicare Pharmacy Help Desk
Toll Free: 1-877-935-8021

Prior Auth Requests

Phone: 1-866-399-0928
Fax: 877-941-0480

In-Clinic Rx Administration

Phone: 1-800-218-7453 ext. 22080 (Medicaid/CHIP)

1-800-218-7453 ext. 22272 (Medicare/STAR Health (foster care)/STAR+PLUS)
Fax: 1-866-683-5631

Out-Patient Rx (PBM: US Script) 

Resolution Help Desk: 1-800-460-8988

Prior Auth Requests Phone: 1-866-768-7147

Prior Auth Requests Fax: 1-866-399-0929

Pharmacy & Help Desk

Toll Free: 1-866-768-0468

TTY: 1-866-492-9674

Appeal Requests (Superior Prior Authorization Department)
Toll Free: 1-877-398-9461 ext. 22168
Fax: 1-866-918-2266