Skip to main content

Pharmacy

WellCare of South 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.

    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.

    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.

    Printable PDLs


    The Preferred Drug List contains information about drugs covered by the plan.

    At the December 14,2017 WellCare Pharmacy & Therapeutics Committee meeting, it was decided that the following changes will be made to the WellCare’s South Carolina Medicaid Preferred Drug List (PDL), effective 02/27/2018.

    Additional Information

    Exactus Specialty Pharmacy

    The WellCare Specialty Pharmacy offers expert service in the special handling, storage and administration of medications for members who have long-term, life-threatening or rare conditions. With its knowledge of the insurance process and plan benefits, the team can speedily help the patient receive his or her medication. For a detailed list of conditions covered, 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.
    • Exactus Specialty Pharmacy

      Exactus Specialty Pharmacy

      The WellCare Specialty Pharmacy offers expert service in the special handling, storage and administration of medications for members who have long-term, life-threatening or rare conditions. With its knowledge of the insurance process and plan benefits, the team can speedily help the patient receive his or her medication. For a detailed list of conditions covered, 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.
    contac-us

    Need help? We're here for you.

    Contact Us
    Last Updated On: 5/8/2017