On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. Learn more about this from Change Healthcare, or reach out to the contact center at 1-866-262-5342.
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Pharmacy Benefits
show Pharmacy Benefits menu
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- Find a Doctor or Pharmacy
- List of Drugs (Formulary)
- Medication Therapy Management (MTMP)
- Mail Order Service
- Specialty Pharmacy
- Coverage Determinations and Redeterminations
- Prior Authorization, Step Therapy & Quantity Limitations
- Out-of-Network Pharmacies
- Medication (Drug) Management and Safety
- Drug Transition Policy
- Pharmacy Forms
- Medicare Prescription Payment Plan
-
On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. Learn more about this from Change Healthcare, or reach out to the contact center at 1-866-262-5342.
- Shop for Plans show Shop for Plans menu
- I'm a Member show I'm a Member menu
-
Pharmacy Benefits
show Pharmacy Benefits menu
-
- Find a Doctor or Pharmacy
- List of Drugs (Formulary)
- Medication Therapy Management (MTMP)
- Mail Order Service
- Specialty Pharmacy
- Coverage Determinations and Redeterminations
- Prior Authorization, Step Therapy & Quantity Limitations
- Out-of-Network Pharmacies
- Medication (Drug) Management and Safety
- Drug Transition Policy
- Pharmacy Forms
- Medicare Prescription Payment Plan
-
Pharmacy Forms & Notices | Wellcare Oklahoma
Pharmacy Forms & Notices
Here’s a list of pharmacy documents and forms you may need when using your Medicare Part D benefit. If you have questions about these items, please contact Member Services. We’re here to help.
- Prescription Drug Claim Form-English (PDF) - coming soon
- Prescription Drug Claim Form-Spanish (PDF) - coming soon
- Express Scripts Mail Order Form-English (PDF) - coming soon
- Express Scripts Mail Order Form-Spanish (PDF) - coming soon
- Covered Diabetes Testing Supplies - (PDF) - coming soon
Pharmacy Forms & Notices
Here’s a list of pharmacy documents and forms you may need when using your Medicare Part D benefit. If you have questions about these items, please contact Member Services. We’re here to help.
If you have questions, please contact Member Services.
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