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Who May Make a Request

Your prescriber may ask us for an appeal on your behalf. If you want another individual (such as a family member or friend) to request an appeal for you, that individual must be your representative. Contact Us to learn how to name a representative.

Because we, Wellcare, denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for redetermination (appeal) of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. This form may be sent to us by mail or fax:

Address  Fax Number
 Wellcare Health Plans
P.O. Box 31383
Tampa, FL 33631
 1-866-388-1766

Expedited appeal requests can be made by phone at 1-888-550-5252.

Enrollee's Information ?

Enrollee's Contact Information

Requestor's Contact Information ?

Prescription Drug Information

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Prescriber's Information

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Last Updated On: 5/23/2016
Medicare 가입자: Medicare 사기로부터 자신을 보호하고 도난을 식별하십시오! 미국 보건복지부(Department of Health and Human Services) 감사관실(Office of Inspector General)은 유전자 검사와 관련된 사기 수법에 대해 대중에게 경고하고 있습니다. 자신을 보호하는 방법을 알아보십시오.
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