Mga Parmasyang nasa Network
Tinatanggap ang Wellcare sa mahigit 60,000 parmasya sa network sa buong bansa. Pinapadali nito na makuha ang mga gamot ninyo. Kabilang sa aming network ang malalaking chain na parmasya, mga independent na retail na parmasya, mga parmasya ng mail order na serbisyo, mga parmasya para sa pangmatagalang pangangalaga, mga parmasya para sa home infusion, at mga parmasya ng Indian Health Service/Tribal/Urban Indian Health Program (I/T/U).
Bilang isang miyembro, puwede ninyong kunin ang inyong mga reseta sa anumang parmasyang nasa network. Kung kukunin ninyo ang inyong reseta, ipakita lang ang inyong ID card ng Miyembro sa Wellcare.
Para sa higit pang impormasyon tungkol sa pagkuha ng mga reseta ninyo sa mga parmasyang nasa network, mangyaring sumangguni sa inyong Katibayan ng Pagsaklaw.
Serbisyo ng Mail Order
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 Express Scripts® Pharmacy Mail Order Service page.
Mga Parmasyang Wala sa Network
May libo-libo kaming parmasya sa aming network sa buong bansa para mapadali ang pagkuha ninyo ng inyong mga gamot. Gayunpaman, alam namin na may mga pagkakataong hindi kayo makakagamit ng isang parmasyang nasa network. Puwede naming saklawin ang mga gamot na kinuha sa isang parmasyang wala sa network kung:
- Walang bukas na parmasyang nasa network na malapit sa inyo, o
- Kailangan ninyo ng gamot na hindi ninyo makukuha sa isang parmasyang nasa network na malapit sa inyo, o
- Kailangan ninyo ng gamot para sa emergency o agarang pangangalagang medikal, o
- 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.
Reimbursement ng Reseta
If you need to ask us to pay you back for prescriptions paid out of pocket:
- Complete the Prescription Drug Claim Form using the link below.
- 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.
- 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.
- 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.
- 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)
Pagkatanggap namin sa inyong kahilingan, ipapadala namin sa mail ang aming desisyon (pagpapasya sa pagsaklaw) kasama ang isang reimbursement check (kung naaangkop) sa loob ng 14 na araw.
For specific information about drug coverage, please refer to your Evidence of Coverage or Contact Us. We are here to help.
