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.
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.
Retail pharmacy fax:
Medical injectables (medical benefit) fax:
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.
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:
Medicare Part D
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.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Policies, Guidelines & Manuals
- Provider Training Academy
- Pharmacy Information
- Electronic Data Interchange
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