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Pharmacy

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

Preferred Drug List (PDL)

The PDL and supplemental drug lists are clinical guides to prescription drug products selected by Nebraska and WellCare's Pharmaceutical and Therapeutics (P&T) Committees, respectively, based on a drug's efficacy, safety, side effects, pharmacokinetics, clinical literature and cost effectiveness.

For questions regarding filling a prescription, please contact us at 1-855-599-3811 (TTY 1-877-247-6272).

Maximum Allowable Cost (MAC) Pricing and Pharmacy Provider Manual

WellCare partners with CVS/caremark™ to promote better health outcomes for our members. CVS/caremark is our pharmacy benefit manager (PBM) for this line of business, and some of our pharmacy resources can be found on the CVS website.

To access MAC pricing information and the pharmacy provider manual, as well as submit a MAC appeal, please log into the CVS website.

You will need to create an account if you do not already have one. To access CVS/caremark Login, providers may use the following information:

  • Independent/Affiliated Independent Pharmacies
    Providers will be prompted to set a unique username and password as part of the initial login process. 

    Please note:
    Detailed pharmacy-specific account information must be entered as part of the initial login process including, but not limited to: pharmacy NCPDP number (seven digits), pharmacy NPI, state license number, and DEA number.

  • Pharmacy Chain/PSAO Headquarters Only
    Contact your respective Network Account Manager for details regarding your preset login information.

  • Existing Users
    If you have already accessed the website, you do not need to set a new username/password to view the MAC Price information.

Helpful Documents


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

At the June 7, 2018 WellCare of Nebraska Pharmacy & Therapeutics Committee meeting, it was decided that the following changes will be made to the WellCare of Nebraska Supplemental Drug List (DL), effective 08/21/2018.

A supplemental list of medications for members.

Supplemental Drug List information

A list of medications for Dual-Eligible members.

A list of medications for Medicaid members.

At the December 14,2017 WellCare of Nebraska Pharmacy & Therapeutics Committee meeting, it was decided that the following changes will be made to the WellCare of Nebraska Family Planning Preferred Drug List (DL), effective 02/27/2018.

Please complete and submit this form to request prior authorization for injectable infusions from the WellCare of Nebraska Medicaid plan.

This brochure contains member over-the-counter benefits.

Other Helpful Information

Specialty Pharmacy

You can find pharmacies using our Find a Provider pharmacy search tool.

One of these pharmacies includes Exactus Speciality Pharmacy, which is WellCare's specialty pharmacy. For a detailed list of conditions covered and how to use Exactus Specialty Pharmacy, 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.

Over-the-Counter Benefits

We encourage providers to alert members they can receive a monthly credit of up to $10 per household for personal care products delivered right to their home. Examples include items such as vitamins and cough medicine.

  • Specialty Pharmacy

    Specialty Pharmacy

    You can find pharmacies using our Find a Provider pharmacy search tool.

    One of these pharmacies includes Exactus Speciality Pharmacy, which is WellCare's specialty pharmacy. For a detailed list of conditions covered and how to use Exactus Specialty Pharmacy, 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.
  • Over-the-Counter Benefits

    Over-the-Counter Benefits

    We encourage providers to alert members they can receive a monthly credit of up to $10 per household for personal care products delivered right to their home. Examples include items such as vitamins and cough medicine.

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Last Updated On: 5/8/2017