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Who May Make a Request

Your prescriber may ask us for an appeal on your behalf. If you want another individual (such as a family member or friend) to request an appeal for you, that individual must be your representative. Contact us to learn how to name a representative.

Because we, WellCare, denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for redetermination (appeal) of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. This form may be sent to us by mail or fax:

Address Fax Number 

Today’s Options
PO Box 31383

Tampa, FL 33631


Expedited appeal requests can be made by phone at:

Health Plan
Phone Number 

Today’s Options HMO

Today's Options PFFS

Today's Options PPO




Enrollee's Information ?

Enrollee's Contact Information

Requestor's Contact Information ?

Prescription Drug Information


Prescriber's Information

Print Form

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Last Updated On: 11/27/2017