The retail outpatient pharmacy services are a non-covered Plan benefit. Retail pharmacy services are covered by the State Medicaid program on a fee-for-service basis.
Harmony Health Plan does provide its members pharmacy services for injectable drugs and infusion products administered in a provider’s office. Injectable products and all infusion drug requests require a Drug Evaluation Review and are supplied by a specialty vendor arranged by the Plan. Specialty drugs require a DER and are not available through the retail pharmacy network.
Injectable/Infusion Drug Evaluation Review Request Form
Enteral Nutrition Supplement Form
For detailed information about pharmacy services, refer to the pharmacy section of the Provider Manual.
The WellCare Pharmacy Department telephone number is 1 (877) 647-7473.
