Pharmacy information and tools
Wellpoint works with CarelonRx to administer pharmacy benefits for enrolled members.
Medicaid
Please refer to the Preferred Drug List (PDL) when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.
Most medications on the PDL are covered without prior authorization, but there may be some that require you to contact our Pharmacy department for authorization.
Pharmacy prior authorizations
By phone
Call the Wellpoint Pharmacy department at 1-833-707-0868 Monday to Friday from 8 a.m. to 8 p.m. Eastern time, or 10 a.m. to 2 p.m. on Saturday.
By fax
Fax your request to our Pharmacy department.
Pharmacy outpatient drugs: Fax the Pharmacy Prior Authorization Form to 1-844-490-4871.
Medical injectable drugs: Fax the Medical Injectables Prior Authorization to 1-844-490-4873.
Mail order pharmacy
Wellpoint offers mail-order pharmacy services for certain drugs through CarelonRx’s home delivery pharmacy. To obtain mail-order pharmacy services:
By fax
Fax your mail-order request to 1-800-378-0323.
Related information
Medicaid formulary, drug criteria and limitations
Prior authorization lookup tool
Preferred Drug List (PDL) - English
Preferred Drug List (PDL) - Spanish
Medical Injectable Prior Authorization Form
State Hepatitis C Clinical Criteria
State Hepatitis C Sample Treatment Plan
Hepatitis C Therapy Prior Authorization Form
State Hepatitis C Retreatement Form
State Opioid Prescribing Guidance and Policy (Resource)
State Opioid Prescribing Policy
Analgesic Opioid Quantity Limits
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Hot Tips
Pharmacy Hot Tips are brief messages to help to provide preferred formulary products used to treat common diseases and conditions such as asthma and diabetes. If you would like additional pharmacy information to assist our members, contact Provider Services, and we’ll prepare a Pharmacy Hot Tip for you!
Hot Tip: Proton Pump Inhibitors
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