| Thank you for being a loyal customer of WellCare Health Plans. On this page you will be able to quickly find all the forms that you as a previous member may need. To view an online version of the 2009 summary of benefits or evidence of coverage please click on the words Plan Information at the end of this paragraph. You will be prompted to select your state and county that you live in. Once you make that selection please choose the plan that you were enrolled in prior to January 1, 2010 by clicking on the words View Details to the right of the Plan Name. The page will refresh itself and then you can scroll to the bottom of the page to find a link to the 2009 Evidence of Coverage or the Summary of Benefits. Plan Information |
Please Note: The customer service days and hours of operation reflected in your printed materials have been revised. The new hours are Monday-Friday, 8 am to 8 pm Eastern.
Fitness and HealthStuff (Over-the-Counter Items)
HealthStuff (Over-the-Counter Items) Claim Form -2009 (PDF Listing)
Non-Participating Fitness Center Claim Form -2009 (PDF Listing)
Provider Directories
Dental, Vision and Hearing Providers- 2009 (PDF Listing)
Primary Care Physician Providers - Arkansas 2009 (PDF Listing) or California 2009
To find a dental, vision, hearing or primary care physician (only in select counties in Arkansas and California) provider near you please click here: Find A Provider
Coverage Determination Forms
Prescription Drug Extra Help Checklist
Appointment of Representation Form
Prescription Drug Forms and Formulary
Prescription Drug Coverage Determination Request Form
Injectable/Infusion Prescription Order Form
Prescription Drugs Direct Member Reimbursement Form
Formulary - 2009 (PDF Listing)
Formulary Update - 2009 (PDF Listing)
Appeals & Grievances - this page will give you information about the WellCare Private-fee-For Service Appeals & Grievances process.
