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Member FAQ
Frequently Asked Questions from Members
Members often ask questions about their health plan when visiting their provider. They may also call Customer Service at 1-866-231-1821 (TTY/TDD: 1-877-247-6272) for help. Here is a list of the some of the questions that are asked.
 
Q: I've lost my member ID card. How can I get a new card? 
Use the Web or call Customer Service at 1-866-231-1821 (TTY/TDD: 1-877-247-6272) to ask for a new ID card. To get a new Medicaid card, call 1-800-766-4456.

Q: Do I need a referral to see a specialist? 
Yes, the PCP must provide a referral or script to see a specialist for the initial visit. Follow-up visits to see a specialist require authorization from the plan.

Q: Where can I get my prescriptions filled? 
Prescriptions written by providers that work for WellCare must be filled at a participating pharmacy. You can log on to georgia.wellcare.com for a list of pharmacies. You can also call Customer Service at 1-866-231-1821 (TTY/TDD: 1-877-247-6272) to use our voice response system or speak to a representative to obtain a list of pharmacies you can use.

Q: What is a Preferred Drug List (PDL)? 
The PDL is a list of medications developed by WellCare that providers use when prescribing medications for members. WellCare will only pay for the medications that are listed on the PDL with a few exceptions. The PDL is updated every 3 months. Providers can also tell you if a certain drug is on the PDL.

Q: How much do services cost?
For some services, there is no cost. There are co-pays for services like prescription drugs. Information on covered services and co-pays can be found in the member handbook.

Q: What happens if I need care over a weekend when your office is closed? Should I go to the emergency room? 
If it is an emergency, go to the emergency room right away for care. If it is not, your PCP can be reached 24 hours a day, 7 days a week. After-hours care may be provided by a 24-hour answering service which will give the following options:

  • Page the physician
  • An advice nurse with access to the PCP
  • On-call PCP
  • You may also call the Health Advice Line at 1-800-919-8807 for help with level of care decisions
 
 

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