Pharmacy information

Wellpoint Iowa, Inc. administers pharmacy benefits for enrolled members, and CarelonRx* is the pharmacy benefits manager. Most medications are covered without prior authorization, but a few require you to contact our pharmacy department for prior approval.

Formularies

Iowa Medicaid Preferred Drug List (PDL)

• Medicare Advantage — 2021 Formulary

Medicaid

The Iowa Medicaid PDL  contains a comprehensive list of drugs in commonly prescribed therapeutic categories, including preferred and nonpreferred drugs, and drugs requiring prior authorization.

Stay current on Iowa Medicaid pharmacy updates with the informational letters published by Iowa Department of Human Services.

Medicaid pharmacy authorizations

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Call or fax your request to our Pharmacy department, or use CoverMyMeds^® to submit electronically.

Phone:

1-833-731-2143

ePrescribe:

CoverMyMeds®

Retail pharmacy fax:

1-844-512-9004

Medical injectables (medical benefit) fax:

1-844-512-7026

Medicare

Please refer to the Iowa Medicare formulary when prescribing for Medicare members. Though most medications on the formulary are covered without prior authorization, a few require you to obtain an approval.

Medicare pharmacy authorizations

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Medicare Part B
Call Provider Services:

1-877-411-0929

Medicare Part D
Call CarelonRx:

Reference member ID card for phone number.

Related information

Forms 

Prior authorization lookup tool 

• 340B Drug Pricing Program
• Dual Eligible LINET Program
• Dual Eligible LINET Quick Reference Guide
• State Pharmacy Prior Authorization Process