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Pharmacy

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Pharmacy

WellCare is committed to working with providers to improve members' health and well-being. The following information will help your patients get the most out of their pharmacy benefits.

Preferred Drug Lists

The PDL is a clinical guide of prescription drug products selected by WellCare's Pharmaceutical and Therapeutics (P&T) Committee based on a drug's efficacy, safety, side effects, pharmacokinetics, clinical literature and cost-effectiveness.

Florida Agency for Health Care Administration (AHCA)

Coverage Determination Requests

Request a coverage decision and/or exception or file an appeal of a drug coverage decision.

Medication Appeals

You may appeal a coverage determination decision by contacting our Pharmacy Appeals Department. Please complete a medication appeal request.

Other Helpful Information

Exactus Specialty Pharmacy

The WellCare Specialty Pharmacy offers expert service in the special handling, storage and administration of medications for members who have long-term, life-threatening or rare conditions. With its knowledge of the insurance process and plan benefits, the team can speedily help the patient receive his or her medication. For a detailed list of conditions covered, please visit our Exactus Specialty Pharmacy page.

Medical Injectables

WellCare's medical injectables' prior authorization requirements are aligned with current industry practice. Most self-injectable and infusion medications require prior authorization. Use our authorization look-up tool to search quickly and easily by CPT code.
  • Exactus Specialty Pharmacy

    Exactus Specialty Pharmacy

    The WellCare Specialty Pharmacy offers expert service in the special handling, storage and administration of medications for members who have long-term, life-threatening or rare conditions. With its knowledge of the insurance process and plan benefits, the team can speedily help the patient receive his or her medication. For a detailed list of conditions covered, please visit our Exactus Specialty Pharmacy page.
  • Medical Injectables

    Medical Injectables

    WellCare's medical injectables' prior authorization requirements are aligned with current industry practice. Most self-injectable and infusion medications require prior authorization. Use our authorization look-up tool to search quickly and easily by CPT code.
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Last Updated On: 12/4/2020