Wellcare Value Script (PDP)

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

Farmacias de la Red

Wellcare se acepta en más de 60,000 farmacias de la red a nivel nacional. Esto facilita la obtención de sus medicamentos. Nuestra red incluye las principales cadenas, farmacias minoristas independientes, farmacias de envíos por correo, de atención a largo plazo, de infusión en el hogar y del Programa de Salud para Indígenas Estadounidenses Urbanos/Tribales/Servicio de Salud para Indígenas Estadounidenses.

Como miembro, puede surtir sus recetas en cualquier farmacia de la red. Cuando surta una receta en una farmacia participante, simplemente muestre su tarjeta de identificación de miembro de Wellcare.

Para obtener más información sobre cómo obtener sus recetas en farmacias de la red, consulte su Evidencia de Cobertura.

Servicio de Envíos por Correo

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.

Farmacias fuera de la Red

Tenemos miles de farmacias en nuestra red nacional para facilitar la obtención de sus medicamentos. Sin embargo, sabemos que puede haber ocasiones en las que no pueda utilizar una farmacia de la red. Podemos cubrir sus medicamentos surtidos en una farmacia fuera de la red en los siguientes casos:

• No hay una farmacia de la red que esté cerca de usted y que esté abierta.
• Necesita un medicamento que no puede obtener en una farmacia de la red cerca de usted.
• Necesita un medicamento para atención médica urgente o de emergencia.
• 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.

Reembolso de Recetas

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.

• Prescription Drug Claim Form - English (PDF)
• Prescription Drug Claim Form - Spanish (PDF)
• Appointment of Representative Form CMS 1696 - English (PDF)
• Appointment of Representative Form CMS 1696 - Spanish (PDF)

Después de recibir su solicitud, le enviaremos por correo nuestra decisión (determinación de cobertura) con un cheque de reembolso (si corresponde) dentro de los 14 días. 

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.

Farmacia Especializada

Nuestras farmacias especializadas están disponibles sin costo adicional para los miembros que toman medicamentos utilizados con el fin de tratar afecciones crónicas a largo plazo, complejas o poco comunes, como cáncer, artritis reumatoide, VIH o hemofilia. Podemos ayudarlo a controlar los efectos secundarios y los síntomas, asegurar que tome los medicamentos de manera oportuna y según lo recetado, y guiarle en el resurtido de pedidos.

2024 Members Only:

• Optum Specialty Pharmacy: 1-855-427-4682

2024 & 2025 Members:

• AcariaHealth Pharmacy: 1-855-535-1815
• Accredo Health Group: 1-833-750-9975
• CVS Caremark Specialty Pharmacy: 1-800-237-2767
• Walgreens Specialty Pharmacy: 1-888-782-8443

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.