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Pharmacy Services

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Drug Evaluation Request Forms

Pharmacy Services Documents

A preferred drug list is a list of drugs covered by your plan.

This is a list of changes to our preferred drug list. We made the changes as a result of the latest WellCare Pharmacy & Therapeutics meeting on 06/13/2019.

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

Fill out and submit this form to request an appeal for Medicaid medications.


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Last Updated On: 3/16/2017
Medicare and Prescription Drug Plan Members: A new and enhanced member portal will soon be available. This portal will offer a fresh homepage, all new billing and payment options for 2020, and more! Check back on 10/15 to see what else is new. ×