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
No Authorization Required Medical Injectible List- Effective December 7, 2010
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.