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Mga Parmasya

Network Pharmacies

Wellcare is accepted at over 60,000 network pharmacies nationwide. This makes it easy for you to get your drugs. Our network includes major chains, independent retail pharmacies, mail order service pharmacies, long-term care, home infusion and Indian Health Service/Tribal/Urban Indian Health Program pharmacies.

As a member, you may fill your prescriptions at any network pharmacy. When you fill your prescription, simply present your Wellcare Member ID card.

For more information about filling your prescriptions at network pharmacies, please refer to your Evidence of Coverage.

Mail Order Service

For certain kinds of prescription drugs, you can use our preferred mail order service –CVS Caremark®. You have the choice to get up-to-a 90-day supply of your drugs shipped directly to your home discreetly and free with standard delivery. This can save you time, money, and trips to the pharmacy.

For more information, please visit our Mail Order Service page located on this website. You may also call CVS Caremark® Member Services at 1-866-808-7471 (TTY: 711) 24 hours a day, 7 days a week.

Out-of-Network Pharmacies

We have thousands of pharmacies in our nationwide network to make it easy to get your drugs. However, we know there may be times when you can't use a network pharmacy. We may cover your drugs filled at an out-of-network pharmacy if:

  • There isn’t a network pharmacy that is close to you and open, or
  • You need a drug that you can’t get at a network pharmacy close to you, or
  • You need a drug for emergency or urgent medical care, or
  • 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 medical emergency.

If you must use an out-of-network pharmacy, you generally will 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.

How do you ask for reimbursement from us?

  1. Complete the Prescription Claim Form below.
  2. Attach the original prescription receipt to the form. If you do not have the original receipt, you can ask your pharmacy for a printout. Do not use cash register receipts. It is also a good idea to make a copy of your bill and receipts for your records.
  3. Mail the completed form and receipt to the address on the form. You must submit your claim to us within three years of the date you received your drug.

Prescription Claim Form - English Magbubukas ang PDF na dokumentong ito sa bagong window.

After we receive your request, we will mail our decision (coverage determination) with a reimbursement check (if applicable) within 14 days. 

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

Impormasyon tungkol sa Parmasya

Pag-fill sa Iyong Reseta

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

Learn how to fill your prescriptions through WellCare's Preferred Mail-Service Pharmacy.

Kumuha ka ba ng inireresetang gamot sa isang parmasyang nasa labas ng aming network? Alamin pa ang tungkol sa aming wala sa network na saklaw.

Sumangguni sa Ebidensya ng Saklaw o Evidence of Coverage para sa higit pang impormasyon tungkol sa bahagi mo sa gastos sa reseta.

Humingi ng Electronic na Form ng Pagdetermina ng Saklaw sa Inireresetang Gamot ng Medicare

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Use this printable form to ask us for a decision about a prescription drug and your specific plan coverage. Providers and members should fax form to 1-866-388-1767.

Request for Redetermination of Medicare Prescription Drug Denial (Appeal) Electronic Form)

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Complete this printable form to ask for an appeal after being denied a request for coverage or payment for a prescription drug. This is the same form as above but cannot be submitted electronically. Request for Redetermination of Medicare Prescription Drug Denial (Appeal) Magbubukas ang PDF na dokumentong ito sa bagong window.

Matuto Pa

Parmasya para sa Pag-o-order sa Mail

Ang CVS Caremark Mail Service Pharmacy ay ang preferred na mail-service na parmasya ng WellCare. Makakatanggap ka ng hanggang tatlong buwang supply ng iyong gamot sa mismong bahay mo.

Exactus Specialty Pharmacy

Bakit ako dapat gumamit ng Exactus Specialty Services?

Available ang mga preferred na specialty na serbisyo ng parmasya ng WellCare nang walang dagdag na gastos sa mga miyembro na umiinom ng gamot para sa mga kondisyong pangmatagalan, nakamamatay, o rare (bihira). Kabilang sa platform ng aming mga serbisyo ang pagtulong sa mga miyembro na makontrol ang mga side effect at sintomas, mag-order ng mga refill, matutunan kung paano makainom ng mga gamot sa mas mahusay na paraan, at higit pa.

 

Extra Help for Prescription Drugs

Learn how to submit your proof of eligibility for Prescription Drug Extra Help:

2015

English  Magbubukas ang PDF na dokumentong ito sa bagong window.  Spanish  Magbubukas ang PDF na dokumentong ito sa bagong window.  Chinese  Magbubukas ang PDF na dokumentong ito sa bagong window.  Vietnamese

View valid evidence of low-income eligibility Magbubukas ang PDF na dokumentong ito sa bagong window. (Best Available Evidence).

Makakuha ng higit pang impormasyon tungkol sa Pinakamahusay na Available na Ebidensya mula sa Medicare.


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Y0020_WCM_87476E Huling Na-update Noong: 10/1/2021