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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.

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.

Consent Form

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.

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Last Updated On: 5/7/2021