MAPD: HMO, C-SNP, D-SNP, PPO
Preferred Pharmacy Network
Wellcare’s Medicare Advantage* and Prescription Drug Plans offers a robust, dependable pharmacy network with over 60,000 pharmacies in network — many offering preferred cost-sharing.* A member’s cost-share may be lower when prescriptions are filled through one of our preferred retail pharmacies or our preferred mail-order pharmacy, Express Scripts.® However, members may have prescriptions filled at any network pharmacy. Walgreens®, CVS®, grocers, and select independents pharmacies remain within the preferred 2024 pharmacy network. Amazon® is no longer a preferred pharmacy but remains in the pharmacy network.
Remember, some retail pharmacies offer both retail and home delivery options. If a member fills a prescription with a retail pharmacy that also offers home delivery, the retail cost share will apply. Pharmacies may charge a delivery fee.
Please utilize the Find a Provider tool to find an in-network pharmacy. This will also allow you to find an in-network pharmacy’s network status (standard vs preferred and if 90/100-day fill is offered).
*Preferred pharmacy network not available for Wellcare D-SNPs.
Formulary Updates
Medicare Advantage prescription drug (MAPD) members can receive up to a 100-day supply of qualifying medications with each fill for non-specialty medications at all in-network pharmacies.
The formulary GLP-1 agonists Bydureon Bcise®, Mounjaro®, Ozempic®, Rybelsus® and Trulicity® will require prior authorization (PA) to confirm medically-appropriate use for the treatment of type 2 diabetes (not covered for weight loss, pre-diabetes, type 1 diabetes, or heart disease prevention). The PA applies to all new and existing users of GLP-1 agonists.
Introducing Express Scripts Pharmacy®
Express Scripts Pharmacy® is Wellcare’s preferred mail order provider, replacing CVS Caremark®. CVS Caremark Mail Order® is out-of-network in 2024.
For existing mail order users:
- Most open prescription refills have been automatically transferred to Express Scripts.® Refills of controlled drugs were NOT automatically transferred. Members must request new prescriptions from their providers.
- Members with new mail-order prescriptions may either:
- Visit express-scripts.com/rx to register or sign in, then follow the guided steps to request a prescription; OR
- Call Express Scripts Pharmacy® at 1-800-282-2881 of 1-833-750-0201.
¿Tiene alguna pregunta?
If you have questions, please contact your Provider Engagement Administrator, call Wellcare Provider Services at 1-855-538-0454 or visit Wellcare.com/Florida. Stay up to date on Wellcare provider notices by reviewing and bookmarking Provider Bulletins.
