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Our Pharmacy Management program coordinates the delivery of our pharmacy benefit. The pharmacy benefit may be included in your base medical plan or may be an optional benefit. Your WellChoice card will indicate if Pharmacy Management is included in your plan. For more information, call the Member Services number on the back of your ID card.
In-Network

Purchasing prescription drugs is fast and easy when you use WellChoice Pharmacy Management participating pharmacies. Just show your WellChoice ID card and pay the applicable copayment or deductible. For members taking prescription drugs for chronic conditions, we offer the convenience of our Mail Order program. Your doctor can prescribe up to a 90-day supply that will be delivered right to your door.

Features:

- 4,900 local pharmacies.
- 47,000 pharmacies nationwide.
- Mail order prescription service.
- No claim forms to fill out.
For more information about our Rx mail order service, download the Caremark Mail Order form below.
Caremark Mail Order

Out-of-Network

Some of our pharmacy options have an out-of-network benefit. When you go out of network you can have your prescription filled at any non-participating pharmacy. Just pay for the cost of the prescription and submit a pharmacy claim form. WellChoice will reimburse you for covered expenses minus any deductible and coinsurance that you're responsible for paying.

Pharmacy Claim Form

The Prescription Drug Formulary

The Formulary is an abbreviated version of our preferred medication list and contains the most commonly prescribed medications. Use it to save money on prescription drugs. All it takes is 2 easy steps. Step 1 - Print or request a copy of the formulary and carry it with you when you visit your doctor. Step 2 - Ask your doctor to consider prescribing a generic medication on the list or ask your pharmacist to suggest a generic substitution for your doctor to consider.

Prescription Drug Formulary

Prior Authorizations and Quantity Limits

Make sure your doctor gets approval from WellChoice for any medications that require prior authorization review (PAR) or have quantity limitations (QL).
Prior Authorization Medications
Quantity Limitations
Top 50 Non-Formulary Medications