Lumaktaw iti kangrunaan a linaonna

Who May Make a Request

Your prescriber may ask us for an appeal on your behalf. If you want another individual (such as a family member or friend) to request an appeal for you, that individual must be your representative. Contact us to learn how to name a representative.

Because we, WellCare, denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for redetermination (appeal) of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. This form may be sent to us by mail or fax:

Address Fax Number

WellCare Health Plans
P.O. Box 31383
Tampa, FL 33631

1-866-388-1766

Expedited appeal requests can be made by phone at 1-888-550-5252.

Enrollee's Information ?

Enrollee's Contact Information

Requestor's Contact Information ?

Prescription Drug Information

?

Prescriber's Information

Contact Us icon

Kasapulam ti tulong? Addakam ditoy para kenka.

Awagandakami
Last Updated On: 5/23/2016
Medicare Members: Your materials are on the way! We realize you may be waiting to receive some plan materials and we apologize for any delays. Did you know you can go online to our member portal to view Member materials, review your benefits, request or download an ID card, or choose a physician (when applicable)? Log in or register today!
×