Effective September 1, 2026: Pharmacy and Biopharmacy Policies

Date: 06/30/26

Please Note: This article has been updated as of 07/07/2026.

Effective on September 1, 2026, at 12:00AM, Ambetter from Superior HealthPlan, Ambetter Health (Solutions), and Superior HealthPlan (Medicaid) have added, updated, or retired certain pharmacy and biopharmacy policies. These changes help ensure medical necessity review criteria remain current and appropriate for members and covered services.

All pharmacy and biopharmacy clinical policies are reviewed and approved by the Pharmacy and Therapeutics (P&T) Committee before implementation.

For details, please review the Ambetter and Medicaid Criteria Summary Tables, under the "Criteria Summary Tables" dropdown, on Superior’s Clinical, Payment & Pharmacy Policies.

For questions or additional information, please contact the Centene Pharmacy Services (CPS) Call Center at 1-866-768-7147.