The medications included in the Wellpoint formulary are reviewed and approved by the Pharmacy and Therapeutics Committee, which includes Practitioners and Pharmacists from the Wellpoint Provider community.
Please select a drug from the list below to see all coverage details regarding the medication. Some medications listed may have additional requirements or limitations of coverage. These requirements and limits may include prior authorization, quantity limits, age limits, step therapy or Center for Medicare and Medicaid Services (CMS) coverage requirements.
Medications not listed o n the formulary are considered to be non-formulary and are subject to prior authorization.
Additionally, if a medication is available as a generic formulation, this will be the preferred agent for Wellpoint, unless otherwise noted. If you have any questions about coverage of a certain product, please contact us at 1-833-731-2274, Monday through Friday, 8 a.m. to 5 p.m. PT.
Wellpoint will follow the Washington Health Authority (HCA) PDL for coverage of Atypical Antipsychotics. All members under 18 must utilize state UM's. Children less than 18 years of age that exceed clinically established age/dosing limitations for these medications will require a referral to Second Opinion Network (SON).
Machine Readable Data for Prescription Drug Formulary: Washington Medicaid Machine Readable File
If you believe you have reached this message in error, please attempt to locate your medication alphabetically or by therapeutic class.
If the medication you are looking for is not listed and you have questions about your prescription coverage, please contact us. You, your doctor or someone who is your representative can request that we make an exception to our usual formulary rules.
If you have any questions about coverage of a certain product, please contact us at 1-833-731-2274 .