Iowa Providers

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)

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


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

Note: Please refer to the Iowa Medicaid provider manual for more information on pharmacy benefits and limitations.

Medicaid pharmacy forms

Find retail pharmacy and medical injectable prior authorization forms under the Pharmacy option on our Forms page.

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


Medicare Part B
Call Provider Services:

1-877-411-0929

Medicare Part D
Call CarelonRx:

Reference member ID card for phone number.

Note: Please refer to the Iowa Medicare provider manual for more information, including a mail-order option for Medicare members.

*CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Wellpoint Iowa, Inc.

Provider tools & resources

Interested in becoming a provider in the Wellpoint network?

We look forward to working with you to provide quality service for our members.

Join Our Network