Mga Parmasyang nasa Network
Wellcare Fidelis Dual Align (HMO D-SNP) 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 Dual Liberty (HMO D-SNP) Member ID card.
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
Find more information about receiving your prescriptions through mail service delivery on our 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.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please Contact Us or refer your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
If you must use an out-of-network pharmacy, you may have to pay the full cost when you fill your prescription. You can ask us to pay you back for 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 (EOC) (PDF) or Contact Us. We are here to help.
Specialty Pharmacy
Our specialty pharmacies are available at no extra cost to members taking drugs used to treat long-term, complex, or rare chronic conditions such as cancer, rheumatoid arthritis, H.I.V. or hemophilia. We can help you to manage side effects and symptoms, ensure you take drugs timely and as prescribed, and guide you through order refills.
- 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.
For additional information about in-network drug coverage, using an out-of-network pharmacy, mail order pharmacy, or getting a prescription reimbursement please refer to your Evidence of Coverage or Contact Us. We are here to help.
