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WellCare Prior (Rx) Authorization Form

WellCare Prior (Rx) Authorization Form

Updated October 18, 2023

A WellCare Prior authorization form is a document used for requesting certain prescription drugs or covered/non-covered services. An individual’s policy might not cover certain drugs, procedures, or treatments, and a WellCare prior authorization form allows them, or the prescribing physician, to make a request for insurance coverage of the prescription in question. Not all patients will be granted coverage for the treatment/drug they are requesting just because a prior authorization form was submitted. WellCare often suggest a cheaper prescription or, in some cases, deny coverage for the requested drug and the patient will have to make the purchase out of pocket. WellCare provides government subsidized health coverage and these forms will only be applicable to those who qualify for medicaid/medicare.

  • Form can be faxed to: 1 (866) 825-2884

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