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The Wellfleet Rx Program will be your pharmacy benefit coverage as of September 1, 2026. To access the current version of the Wellfleet Rx Formulary, please visit here. This file is searchable (Ctrl+F) by the name of the medication listed on your prescription label.
| # | If | Then | What Happens Next… | Questions? |
|---|---|---|---|---|
| 1 | The prescription drug that you are taking IS included in the formulary and does not have a ‘PA’, ‘ST’, or ‘QL’ indication in the ‘Requirements / Limits’ Column | Your prescription is included on the Wellfleet Rx formulary and no further action is needed. | You can continue to get your prescription drug as normal. | Contact Wellfleet Customer Service: 833.343.5338 |
| 2 | The prescription drug that you are taking IS included in the formulary but has a ‘PA’, ‘ST’, or ‘QL’ indication in the ‘Requirements / Limits’ Column | Your prescription may require an exception to be submitted by your provider. | Wellfleet will honor your prior authorization from your previous Cardinal Care plan until it expires or for 6 months, whichever is later. If you did not previously require a prior authorization, your provider will need to submit one for you. | Contact Wellfleet Customer Service: 833.343.5338 |
| 3 | The prescription drug that you are taking is NOT included in the formulary | Your provider will be required to either (1) submit for a non-formulary exception or (2) change your prescription to a covered drug. | Your provider can submit an exception request using either ePA software, via fax, or via telephone. For more information, see here. | Contact Wellfleet Customer Service: 833.343.5338 |
