Change in the Pharmacy Network for WellCare Members

October 3, 2023

Effective 1/1/2024, WellCare of North Carolina (WellCare) is changing our pharmacy benefit manager from CVS Caremark to Express Scripts. Providers writing prescriptions for members should continue prescribing as usual. Members will need to confirm that their pharmacy is in network. Most members will not be impacted as Express Scripts is attempting to contract with all pharmacies that were in the CVS Caremark network.

Members that have used a pharmacy that is not contracted with Express Scripts have been notified directly. They have been sent a letter providing a list of up to five in-network pharmacies located nearby their current pharmacy. This impacts less than 1% of WellCare members. We ask that if you are contacted by a member who needs to make a change in their pharmacy that you assist them in moving their prescriptions if needed.

No changes will occur to the preferred drug list, formulary, or prior authorization process as part of this transition. Authorizations obtained under CVS Caremark will be transitioned to Express Scripts.

Members will receive a new ID card in late November or early December with updated information needed to process pharmacy claims with Express Scripts. Members will need to use these new ID cards to receive their prescriptions.

Please continue to use the Pharmacy Service Line at 866-799-5318 to address any questions you may have about pharmacy benefits for our members.

This change is an important part of our focus on providing cost-effective health care to our members. We have worked hard to minimize any disruption to you and our members. Please reach out to us at 866-799-5318 if you have any questions or concerns. We value your partnership.