Wellpoint has a list of preferred drugs chosen for quality and effectiveness for Iowa members. It’s called a Preferred Drug List (PDL). Since the PDL can change at any time, be sure to check back here for updates.
Many drugs on the PDL don’t need preapproval. Drugs not mentioned on the list, though, always require preapproval. This means your doctor must get approval from us before writing prescriptions for unlisted drugs.
Some medicines need preapproval, or an okay from us, before they can be filled. Drugs that require preapproval will be listed with PA next to the drug name. For those medicines, your doctor must submit a preapproval request before you can fill your prescription. Your doctor can call Provider Services at 833-731-2143 or fax the request to 844-487-9292.
Preapprovals are necessary for drugs that:
Have the potential for serious side effects
Should be prescribed only for specific usage
Have a high misuse or abuse potential
May cost more than other preferred drugs
The preapproval process helps us make sure you’re taking medicines safely and correctly.
You may also need preapproval when:
Requesting a higher dosage than recommended
The drug is part of a step-therapy treatment plan
Requesting a brand-name drug that already has an FDA-approved generic version
If your doctor recommends a drug that isn’t on the list, you may request an exception by emailing us at submitmyexceptionreq@Wellpoint.com. Please include a reason why it should be covered.