Skip to main content

Join Our Network

Thank you for your interest in joining WellCare's provider network. If you are submitting this form on behalf of a group, please note that your group only needs to complete and submit this information once. This form is an inquiry for consideration and not an official registration. We will review your request and if we are in need of your specialty, a representative will contact you to help guide you through our formal application process. 

Please note: To become enrolled as a Kentucky Participating Provider you must obtain a Kentucky Medicaid ID Number prior to or when completing this form. Please visit Kentucky's Cabinet for Health and Family Services to complete the enrollment form.

Important CAQH Requirements Checklist

Thank you again for your interest in WellCare!

Please complete the form:

Your Contact Information ?

Print Form
Contact Us icon

Need help? We're here for you.

Contact Us
Last Updated On: 2/16/2022
Action Required! The first time you log in, you will update your online account information. Learn how to get started using EntryKeyID. ×
Wellcare will be performing maintenance on Saturday, September 23, from 6 P.M. EDT to 8 A.M. EDT the next day. You might not be able to access systems or fax during this time. We are sorry for any issues this may cause. Thank you for your patience. If you need assistance, contact us.
×