WellCare of North Carolina is committed to working with providers to improve members' health and well-being. The following information will help your patients get the most out of their pharmacy benefits.
Coverage Determination Request
The coverage determination process enables providers to request an addition or exception.
- Online: Request Prescription Drug Coverage
- Fax or Mail: Complete a request for prescription drug coverage.
Medication Appeals
Providers may appeal a coverage determination decision by contacting our Pharmacy Appeals department via fax, mail, in person or phone. Please refer to the Quick Reference Guide for instructions.
- Online: Request Appeal for Drug Coverage
- Fax or Mail: Complete an appeal of coverage determination request.
Preferred Drug List (PDL)
The Preferred Drug List contains information about drugs covered by the plan. Please check back for updates, as PDLs are periodically amended.
Printed Preferred Drug Lists
- North Carolina Preferred Drug List
- WellCare of North Carolina Comprehensive Drug List
- North Carolina Clinical Criteria
