Pharmacy
Preferred Drug List
This list contains information about drugs covered by the plan. Please check back for updates, as PDLs are periodically amended.
Printed Preferred Drug Lists
- Ohana Quest Integration Preferred Drug List - English (PDF)
- Ohana Quest Integration Dual Eligible Preferred Drug List - English (PDF)
- Ohana Quest Integration Machine Readable File
- Ohana Quest Integration Notice of Change - English (PDF)
Coverage Determination Requests
Request a coverage decision and/or exception or file an appeal of a drug coverage decision.
Medication Appeals
You may appeal a coverage determination decision by contacting our Pharmacy Appeals Department.
Through their ongoing collaboration, WellCare and Surescripts have partnered to provide free ePA services for all your WellCare patients.
Clinical Pharmacy Policies
- Hydroxyprogesterone caproate (Makena/compound) CP-14 - English (PDF)
- Eculizumab (Soliris) CP-97 - English (PDF)
- Mogamulizumab (Poteligeo) CP-139 - English (PDF)
- Factor VIII (Human, Recombinant) CP-215 - English (PDF)
- Factor VIIa Recombinant (NovoSeven RT, SevenFact) CP-220 - English (PDF)
- AbobotulinumtoxinA (Dysport) CP-230 - English (PDF)
- IncobotulinumtoxinA (Xeomin) CP-231 - English (PDF)
- OnabotulinumtoxinA (Botox) CP-232 - English (PDF)
- RimabotulinumtoxinB (Myobloc) CP-233 - English (PDF)
- Eteplirsen (Exondys 51) CP-288 - English (PDF)
- Ocrelizumab (Ocrevus) CP-335 - English (PDF)
- Ceriponase alfa (Brineura) CP-338 - English (PDF)
- Edaravone (Radicava) CP-343 - English (PDF)
- Testosterone (Testopel, Jatenzo) CP-354 - English (PDF)
- Tisagenlecleucel (Kymriah) CP-361 - English (PDF)
- Axicabtagene Ciloleucel (Yescarta) CP-362 - English (PDF)
- Voretigene Neparvovec-rzyl (Luxturna) CP-372 - English (PDF)
- Ibalizumab-uiyk (Trogarzo) CP-378 - English (PDF)
- Patisiran (Onpattro) CP-395 - English (PDF)
- Ravulizumab-cwvz (Ultomiris) CP-415 - English (PDF)
- Caplacizumab-yhdp (Cablivi) CP-416 - English (PDF)
- Elapegademase-Ivlr (Revcovi) CP-419 - English (PDF)
- Onasemnogene abeparvovec (Zolgensma) CP-421 - English (PDF)
- Trientine (Syprine) CP-438 - English (PDF)
- Crizanlizumab-tmca (Adakveo) CP-449 - English (PDF)
- Golodirsen (Vyondys 53) CP-453 - English (PDF)
- Inebilizumab-cdon (Uplizna) CP-458 - English (PDF)
- Belantamab mafodotin (Blenrep) CP-469 - English (PDF)