Pharmacy

The Pennsylvania Department of Human Services (DHS) has a statewide preferred drug list (PDL). Keystone First follows the DHS PDL for drugs and drug classes that are included on the PDL. Keystone First will also cover additional medications that are not on the DHS PDL as a part of our Supplemental Formulary.

Please use the following links to find additional information on the DHS PDL and the Keystone First Supplemental Formulary:

• Pennsylvania Medical Assistance Program Preferred Drug List (PDL) (includes PDF of DHS PDL)
• Keystone First searchable formulary
• Keystone First Supplemental Formulary (PDF)

Tobacco cessation counseling

• Pharmacist Tobacco Cessation Counseling Application (PDF)

Opioid treatment resources

Keystone First continues to carefully review and update our requirements for opioid prescriptions. Our collaborative goal with you is to ensure that our members are receiving the correct treatment for their pain and that opioid utilization is managed and monitored appropriately. We will continue to provide you with the most up-to-date information and resources to attain that goal.

Opioid-related prior authorization request forms:

• Long-acting opioid prior authorization form (PDF)
• Short-acting opioid prior authorization form (PDF)
• Opioid dependence treatments (oral) prior authorization form (PDF)

Opioid treatment information