Preferred Drug List (PDL)
WellCare covers medically necessary drugs required by Medicaid. It is also important to know we use a Preferred Drug List (PDL). The drugs on the PDL are organized by brand and generic name. Quantity, gender and age limitations are also provided.
- Q4 2019 Dual Eligible Preferred Drug List
- Staywell Medicaid Preferred Drug List Update
- 2019 FL Staywell Diabetic Supply Information
- AHCA Pharmacy Page
- AHCA Preferred Drug List
- Drug Criteria
- Summary of Drug Limitations
Coverage Determination Requests
Request a coverage decision and/or exception or file an appeal of a drug coverage decision.
- Online: Request Prescription Drug Coverage
- Fax or Mail: Complete a request for prescription drug coverage
You may appeal a coverage determination decision by contacting our Pharmacy Appeals Department. Please complete a medication appeal request.
- Online: Request Appeal for Drug Coverage using our online form
- Fax or Mail: Complete an appeal of coverage determination request
Some drugs for children 13 and under require a consent form. A parent or legal guardian must complete and sign this form. A separate form is needed for each prescribed drug. Medicaid will no longer pay for these drugs without the signed form. You will need to be able to provide a copy of the form when it is required.
Note: Durable medical equipment (DME) and medical supplies are reviewed and approved, as applicable, through WellCare's DME Services. Diabetic supplies including meters, strips, lancets and alcohol swabs, are covered by Pharmacy Services. Please refer to the Quick Reference Guide for contact information.