Wellcare Medicare Specialty Pharmacy: What You Need to Know
Wellcare is one of the leading providers of Medicare Advantage and Medicare Part D plans, offering members access to a wide range of pharmacy services, including specialty pharmacy support. Understanding how Wellcare integrates specialty pharmacy solutions into its Medicare offerings is essential for managing complex health conditions and maximizing your plan’s benefits.
What Is a Specialty Pharmacy?
A specialty pharmacy provides medications that are typically high-cost, require special handling or administration, and treat chronic or complex conditions such as cancer, multiple sclerosis, or rheumatoid arthritis. These pharmacies also offer clinical services, education, and patient support to help individuals navigate their therapy journey.
Difference Between a Pharmacy and a Specialty Pharmacy
While a retail pharmacy dispenses common prescriptions for routine conditions, a specialty pharmacy focuses on more complex therapies. These services often include:
24/7 clinical support
Personalized medication counseling
Prior authorization assistance
Coordination of benefits
Wellcare Medicare and Specialty Pharmacy Services
Wellcare partners with specialty pharmacies to ensure its Medicare members receive timely access to specialty medications, with enhanced patient care and adherence support.
Preferred Specialty Pharmacies for Wellcare
Wellcare’s preferred network includes Exactus Pharmacy Solutions, one of the key specialty pharmacies in its system. Members may also have access to other partner pharmacies depending on their plan type and location. It’s crucial to check your plan’s formulary and pharmacy directory to identify covered specialty pharmacies.
What Is the Preferred Pharmacy for Wellcare Part D?
Wellcare offers a network of preferred pharmacies for its Medicare Part D prescription drug plans, which typically include:
CVS Pharmacy
Walgreens
Walmart
Exactus Specialty Pharmacy
Using a preferred pharmacy can lead to lower out-of-pocket costs and faster service. Specialty medications are usually managed by mail-order services to ensure proper handling and delivery.
Top 3 Specialty Pharmacies in the U.S.
Across the country, the leading specialty pharmacies include:
CVS Specialty Pharmacy
Accredo (Cigna-owned)
Optum Specialty Pharmacy (UnitedHealth Group)
These pharmacies are known for their wide drug availability, national reach, and high patient satisfaction ratings. Wellcare’s network may include one or more of these providers depending on your plan and location.
What Specialty Pharmacy Does AARP Use?
AARP, through its partnership with UnitedHealthcare, typically uses OptumRx as its specialty pharmacy. This is separate from Wellcare but illustrates the industry trend of integrating managed specialty pharmacy services with Medicare plans.
How to Access Wellcare’s Specialty Pharmacy Services
To get started:
Review your plan documents to understand specialty pharmacy benefits.
Consult your prescribing physician, who may initiate a referral.
Contact Wellcare customer service or visit their member portal to coordinate delivery and support services.
Final Thoughts
The Wellcare Medicare specialty pharmacy network is designed to support members dealing with complex, chronic health conditions by providing high-touch care, specialized medication handling, and cost management. Whether you’re managing a recent diagnosis or ongoing treatment, Wellcare’s specialty pharmacy services help ensure seamless access to the medications you need.
