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Wellcare Value Script (PDP)

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Parmasia

Network Pharmacies
Mail Order Services
Specialty Pharmacy
Out-out-Network Pharmacies
Prescription Reimbursement
Additional Pharmacy Information

Dagiti Parmasia iti Network

Awaten iti aglabes ti 60,000 a parmasia iti network iti entero a pagilian ti Wellcare. Palakaenna daytoy para kenka tapno maala dagiti agasmo. Iraman ti network-mi dagiti kangrunaan a chain, dagiti independiente a parmasia ti retail, serbisio ti korreo, napaut a panangtaripato, infusion iti balay ken dagiti parmasia para iti Serbisio ti Salun-at ti Indian/Tribo/Urban a Programa para iti Salun-at ti Indian (I/T/U).

A kas miembro, mabalin a pakargaam dagiti resetam iti aniaman a parmasia iti network-mi. No kargaam ti resetam, ipakitam laeng ti ID kardmo kas Miembro ti Wellcare.

Para ti ad-adu pay nga impormasion maipapan ti panagkarga kadagiti resetam kadagiti parmasia iti network, maidawat a kitaen ti Ebidensia ti Masakupam.

Serbisio ti Bilin iti Korreo

You can fill your prescription at any network pharmacy. You can also fill your prescription through our preferred mail order service†. This can save you time, money, and trips to the pharmacy.

Find more information about receiving your prescriptions through mail service delivery on our Mail Order Service page.

†Other pharmacies are available in our network.

Dagiti Parmasia iti Ruar ti Network

Adda ti ribu-ribu a parmasiami iti network-mi ti intero a pagilian tapno nalakam a maala dagiti agasmo. Ngem, ammomi a mabalin nga adda dagiti kanito a saanmo a mausar ti parmasia iti network. Mabalinmi a sakupen dagiti agasmo a nakargaan iti parmasia iti ruar ti network no:

  • Awan ti asideg kenka wenno silulukat a parmasia iti network, wenno
  • Kasapulam ti agas a saanmo a maala iti asideg kenka a parmasia iti network, wenno
  • Kasapulam ti agas para ti emerhensia wenno nagannat a medikal a taripato, wenno
  • You must leave your home due to a federal disaster or other public health emergency.

Always Contact Us first to see if there is a network pharmacy near you.

If you take a drug(s) on a regular basis and are planning to travel, be sure to check your supply of the drug(s) before you leave. When possible, take along all the drugs you will need. If you travel within the United States and territories, we may cover your drug at an out-of-network pharmacy for the same reasons as noted above. However, we cannot pay for any prescriptions filled by pharmacies outside of the United States and territories, even for a medical emergency.

If you must use an out-of-network pharmacy, you may have to pay the full cost instead of a copay when you fill your prescription. You can ask us to pay you back for our share of the cost.

Pannakaisubli ti Bayad ti Reseta

If you need to ask us to pay you back for prescriptions paid out of pocket:

  1. Complete the Prescription Drug Claim Form using the link below.
  2. If you want another person to complete this form on your behalf, please include the Appointment of Representative (AOR) Form CMS-1696 with your Prescription Drug Claim Form. This form is located at the link below and can also be found on the Centers for Medicare & Medicaid Services (CMS) website.
  3. Add the prescription label information to the form and include a proof of payment receipt with each claim form you submit. If you do not have the receipt or the information needed to fill out the form, you can ask your pharmacy to help.
  4. Mail the completed form(s) and receipt(s) to the address on the form. You must submit your claim to us within three years of the date you received your drug.
  5. It is also a good idea to keep a copy of the forms and receipts for your records.

Kalpasanmi a maawat ti kiddawmi, ikorreomi ti desisionmi (panangamiris ti masakupan) nga addaan ti tseke ti pannakaisubli ti bayad (no maitutop) iti uneg ti 14 nga aldaw. 

For specific information about drug coverage, please refer to your Evidence of Coverage or Contact Us. We are here to help.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Specialty Pharmacy

Dagiti parmasiami ti espesialidad ket sidadaan nga awan ti surok a gastos kadagiti miembro nga agtomtomar kadagiti agas a maus-usar tapno agasan ti napaut, komplikado, wenno dagiti manmano a chronic a kondision kas ti kanser, rheumatoid arthritis, H.I.V. wenno hemophilia. Mabalin da ka a matulungan nga imatonan dagiti madi nga epekto ken sintomas, siguradoen a tomtomarem iti umiso dagiti agasmo ken kas naireseta, ken igiya da ka babaen kadagiti panagkarga manen ti bilinmo.

2024 Members Only:

2024 & 2025 Members:

For all specialty pharmacies, TTY/TTD users should call: 711

For more information on our specialty pharmacies, please refer to your Evidence of Coverage or, Contact Us.

Impormasion ti Parmasia

Request for Medicare Prescription Drug Coverage Determination

You can use one of the determination forms to complete a Medicare drug coverage request:

Electronic: Complete this electronic form via our website.
Medicare Drug Coverage Request Online Form 

Printable: Complete and fax or mail the form to us.
Medicare Drug Coverage Request Form (PDF)

 

Request for Redetermination of Medicare Prescription Drug Denial (Appeal)

You can use one of the redetermination forms to complete a request for redetermination of Medicare prescription drug denial:

Electronic: Complete this electronic form via our website.
Request for Redetermination of Medicare Prescription Drug Denial Online Form 

Printable: Complete and fax or mail the form to us.
Request for Redetermination of Medicare Prescription Drug Denial Form (PDF)

Ammuem ti Ad-adu Pay

Learn more about Medicare coverage determinations (exceptions) and redeterminations (appeals) on the Centers for Medicare & Medicaid Services website.

Panagkarga Kadagiti Resetam

When you fill your prescription at a participating pharmacy, you will simply need to present your Wellcare Member ID card. You will be responsible for any necessary out-of-pocket expense, if any, according to your Part D benefit.

Learn more about receiving your prescriptions through mail service delivery on the following page:

Did you fill a prescription at a pharmacy outside our network?

Learn more about our out-of-network coverage.

For more information about filling your prescription, please refer to your Evidence of Coverage.

Serbisio ti Bilin iti Korreo

You can fill your prescription at any network pharmacy. You also can fill your prescription through our preferred mail order service. This can save you time, money, and trips to the pharmacy.

Learn more about receiving your prescriptions through mail service delivery on the following page:

Specialty Pharmacy

Dagiti parmasiami ti espesialidad ket sidadaan nga awan ti surok a gastos kadagiti miembro nga agtomtomar kadagiti agas a maus-usar tapno agasan ti napaut, komplikado, wenno dagiti manmano a chronic a kondision kas ti kanser, rheumatoid arthritis, H.I.V. wenno hemophilia. Mabalin da ka a matulungan nga imatonan dagiti madi nga epekto ken sintomas, siguradoen a tomtomarem iti umiso dagiti agasmo ken kas naireseta, ken igiya da ka babaen kadagiti panagkarga manen ti bilinmo.

2024 Members Only: 

2024 & 2025 Members:

For all specialty pharmacies, TTY/TTD users should call: 711

For more information on our specialty pharmacies, please refer to your Evidence of Coverage or, Contact Us.

  • Coverage Determination/ Redetermination

    Request for Medicare Prescription Drug Coverage Determination

    You can use one of the determination forms to complete a Medicare drug coverage request:

    Electronic: Complete this electronic form via our website.
    Medicare Drug Coverage Request Online Form 

    Printable: Complete and fax or mail the form to us.
    Medicare Drug Coverage Request Form (PDF)

     

    Request for Redetermination of Medicare Prescription Drug Denial (Appeal)

    You can use one of the redetermination forms to complete a request for redetermination of Medicare prescription drug denial:

    Electronic: Complete this electronic form via our website.
    Request for Redetermination of Medicare Prescription Drug Denial Online Form 

    Printable: Complete and fax or mail the form to us.
    Request for Redetermination of Medicare Prescription Drug Denial Form (PDF)

    Ammuem ti Ad-adu Pay

    Learn more about Medicare coverage determinations (exceptions) and redeterminations (appeals) on the Centers for Medicare & Medicaid Services website.

  • Panagkarga Kadagiti Resetam

    Panagkarga Kadagiti Resetam

    When you fill your prescription at a participating pharmacy, you will simply need to present your Wellcare Member ID card. You will be responsible for any necessary out-of-pocket expense, if any, according to your Part D benefit.

    Learn more about receiving your prescriptions through mail service delivery on the following page:

    Did you fill a prescription at a pharmacy outside our network?

    Learn more about our out-of-network coverage.

    For more information about filling your prescription, please refer to your Evidence of Coverage.

  • Mail Order Service

    Serbisio ti Bilin iti Korreo

    You can fill your prescription at any network pharmacy. You also can fill your prescription through our preferred mail order service. This can save you time, money, and trips to the pharmacy.

    Learn more about receiving your prescriptions through mail service delivery on the following page:

  • Specialty Pharmacy

    Specialty Pharmacy

    Dagiti parmasiami ti espesialidad ket sidadaan nga awan ti surok a gastos kadagiti miembro nga agtomtomar kadagiti agas a maus-usar tapno agasan ti napaut, komplikado, wenno dagiti manmano a chronic a kondision kas ti kanser, rheumatoid arthritis, H.I.V. wenno hemophilia. Mabalin da ka a matulungan nga imatonan dagiti madi nga epekto ken sintomas, siguradoen a tomtomarem iti umiso dagiti agasmo ken kas naireseta, ken igiya da ka babaen kadagiti panagkarga manen ti bilinmo.

    2024 Members Only: 

    2024 & 2025 Members:

    For all specialty pharmacies, TTY/TTD users should call: 711

    For more information on our specialty pharmacies, please refer to your Evidence of Coverage or, Contact Us.

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Kasapulam ti tulong? Addakam ditoy para kenka.

Awagandakami
Y0020_WCM_134133E_M Last Updated On: 8/15/2023
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