Plans & Benefits: SSI, LTC & Waivers

Are you new to managed care?

If you’re a nursing facility resident or a waiver participant, you might be wondering how this all works. Don’t worry. As one of the country’s leading MCOs for seniors and people with disabilities, we’re experts at serving people like you. We’ll answer any questions you have every step of the way.

Benefits Overview

Our service coordinators work with you, your family and friends, doctors, and community groups. We help you get what you need to live the way you want. We also have special benefits for waiver members and certain members on SSI.

You have no copays for services included in your plan. If you have a spenddown, we will only pay for value-added benefits and services until your spenddown is met. Then you won’t pay anything for services included in your plan.

SSI, LTC & Waivers Brochure

Dental & Vision Benefits Flyer

Extra Benefits and Services

With Amerigroup, you get all your regular KanCare benefits PLUS extra benefits to help you manage your health and life. Read this booklet to learn how to get the most out of your special Amerigroup benefits.

Value-added Benefits Booklet

Pharmacy & Prescription Drugs

Our pharmacy benefits include a wide range of prescriptions and over-the-counter medicines. We work with over 50,000 pharmacies across the U.S.

You have no copays for your prescription drug benefit. If you have a spenddown, we won’t pay for medicines until your spenddown is met. Then you won’t have to pay anything for drugs on the preferred drug list (PDL).

Search for name brand and generic drugs
that are on your formulary:

Searchable Formulary

The formulary is a list of all covered prescription drugs included in your pharmacy benefits.

If you need a drug that isn’t listed on our formulary, you or someone you choose to act for you can request a formulary exception. Just email submitmyexceptionreq@anthem.com.

Preferred Drug List (PDL)

The PDL is a list of drugs from the formulary that your health plan recommends. For non-preferred drugs, you will need to get preapproval (also called prior authorization) from us before you can get them. Just email submitmyexceptionreq@anthem.com.

Preferred Drug List (PDL)

Pharmacy & Prescription Drugs

Express Scripts Registration

ESI Mail Order Form

Prescription Drug Reimbursement Form

Prior Authorization

You can email and ask us for an exception at wrkgp-submitmyexceptionreq@anthem.com.

Drug Interactions and Side Effects

Learn more about drug interactions or side effects on the ESI Drug Information website.

Behavioral Health

If you think you might have a behavioral health issue like depression or substance use disorder, the best thing you can do is get help. We offer lots of ways to help you get started.

Behavioral Health

Help your doctors work together

Eligibility & Enrollment

Join the health plan that gives you more – extra benefits, experience and commitment. Find out if you’re eligible and how to choose Amerigroup.

Eligibility and Enrollment


Part of staying healthy is getting the care you need when you need it, and we make getting there easy.

Transportation Flier

Over-The-Counter (OTC) Catalog

Each month, we’ll give you up to $10 to pay for the OTC products you need to stay healthy. This catalog has information about the items you can order and how to get them.

OTC Catalog

Care Coordination

With your help and help from your PCP and specialists, your service coordinator is here to help make sure all your health care needs are met.

Service Coordination Flier

Frequently Asked Questions

Frequently Asked Questions

Notice of Privacy Practices Update
Grievance (complaint)

How to file a grievance (complaint) with us.

Preapprovals and referrals

How to get a preapproval or referral.