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Pharmacy Services

Staywell Will Pay for the Drugs that Medicaid Requires You to Have.

It is also important to know that WellCare uses a Staywell Preferred Drug List (PDL).

  • The PDL is a list of drugs that we prefer your doctor use
  • The drugs on the PDL are organized by brand and generic name
  • Quantity, gender and age limits are also provided 

Florida Agency for Health Care Administration (AHCA) Links:

13 and Under Requirements:

  • Some drugs for children 13 and under require a consent form
  • A parent or legal guardian must complete and sign this form
  • The parent or legal guardian should fill out a separate form for each prescribed drug
    • Medicaid will no longer pay for these drugs without the signed form. 
    • You and your doctor will need to be able to provide a copy of the form when it is required.
  • Consent form 

If you need help, please call Customer Service. You can reach them at 1-866-334-7927 (TTY 1-877-247-6272). Call Monday through Friday, 8 a.m. to 7 p.m.

Drug Evaluation Request Forms:


Staywell Plan Documents

This preferred drug list includes drugs covered by both Medicare and Medicaid.

Use this form if you pay for a covered prescription drug at retail cost and want to be repaid.

Covered Diabetic Supplies

Fill out and submit this form to request prior authorization (PA) for your Medicaid prescriptions.

Fill out and submit this form to request prior authorization (PA) for your Medicaid prescriptions.

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Last Updated On: 7/24/2018
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