DC Medicaid FAQs 

You may select your PCP from a list of providers in the Wellpoint District of Columbia, Inc. network. As long as they are in our network, you can choose any of the following:

• Family or general practitioner
• Advanced registered nurse practitioner
• Internist
• Pediatrician
• Obstetrician/gynecologist
• Attending specialist (for enrollees requiring specialty care for their acute or chronic conditions or conditions related to a disability)
• Clinics or Federally Qualified Health Centers

You can also search online for providers near your with our easy-to-use Find Care tool.

Please tell us your doctor’s name, and we’ll let you know if they’re in our network. If your doctor is part of the Wellpoint DC network, you can keep them as your PCP. If your PCP is not in our network, we can ask your current doctor to join our network or help you select a new PCP.

Yes, you can change your PCP anytime. Just log into your secure account or call Wellpoint DC Enrollee Services toll-free at 833-359-1384 (TTY 711).

You’ll get your enrollee ID card in the mail within 10 business days from the date we’re notified of your enrollment in Wellpoint DC. The name of your primary care provider (PCP) and primary dental provider (PDP) will be listed on the card. If you haven’t received your enrollee ID card after 10 business days, please call Enrollee Services at 833-359-1384 (TTY 711).

If there is no PCP listed on your enrollee ID card, call Wellpoint DC Enrollee Services at 833-359-1384 (TTY 711) to choose a PCP.

Your prescription medicines will be covered by Wellpoint DC. As long as you have a prescription from your doctor, you can continue to take that medicine. We may talk to your doctor about medications that do the same thing but may be cheaper.

You can get prescriptions filled at any Wellpoint network pharmacy. Our network includes most major chains and many independent community pharmacies. You can search our list of network pharmacies. You can also call Wellpoint DC Enrollee Services at 833-359-1384 (TTY 711) or ask your local pharmacy for help.

Find a pharmacy 

Your doctor can request prior authorization for medicines by calling our Pharmacy department at 800-454-3730.

If you are planning to travel and need to refill your medicine early, call Pharmacy Enrollee Services at 833-214-3604 to request a vacation supply.

If your medicines are lost or stolen, you should contact your doctor to authorize the pharmacy to refill your prescription early. Such requests must include a copy of the police report. The pharmacy may have to contact us for prior authorization. Replacement of lost or stolen medicine will be reviewed on a case-by-case basis. Certain restrictions may apply.

If you had to pay for a medicine, you may submit a request for reimbursement. You’ll need to mail a completed reimbursement request form, along with any receipts, to this address:

Commercial/Medicaid Claims Department

P.O. Box 52065

Phoenix, AZ 85072-2065