Contact Us
Home Provider Medical, Dental, and Pharmacy Pharmacy
» Welcome to Wellmark
» BlueInk
» BlueCard® Program
» Claims and Payment
» Medical Policies and Authorizations
» Health Management Programs
» Medical, Dental, and Pharmacy
» Credentialing and Network Participation
» Communications and Resources
» COVID-19
FEP Drug Authorization and Quantity Limits

Some drugs, and certain amounts of some drugs, require an approval before they can be covered by your patients' benefits.

 

Request approval in advance to help prevent delays in obtaining the drug.

 

To view authorization information for procedures, imaging, and durable medical equipment (DME), please view the medical authorization table.

 

View important details about authorization

 

Drug Authorization Table for non-FEP members

 

All Opioid-related drugs

 

FEP medically benefited drugs require authorization. Click the drug name to see the criteria of the policy.

 

Submit drug authorization request

 

To find a specific drug more quickly, use the keyboard shortcut. On a PC, press ‘CTRL+‘F’ and on a Mac, press 'Cmd+F' and type in the drug name to search.

 

Actemra
Acthar Gel
Aralast NP
Berinert
Bivigam
Botox
Cerezyme
Cimzia
Cinqair
Cinryze
Crysvita
Cutaquiq
Cuvitru
Durolane
Dysport
Elelyso
Entyvio
Epoprostenol
Euflexxa
Fasenra
Flebogamma DIF
Flolan
Gammagard Liquid
Gammagard S/D
Gammaked
Gammaplex
Gamunex C
Gel-One
Gelsyn-3
Genvisc 850
Glassia
Granix
Hizentra
Hyalgan
Hymovis
HyQvia
Inflectra
Ixifi
Kalbitor
Lemtrada
Leukine
Luxturna
Monovisc
Myobloc
Neupogen
Nucala
Ocrevus
Octagam
Onpattro
Opdivo
Orencia
Orthovisc
Privigen
Prolastin-C
Radicava
Remicade
Remodulin
Renflexis
Revatio
Rituxan
Rituxan Hycela
Ruconest
Sandostatin LAR
Signifor LAR
Simponi Aria
Spinraza
Stelara
Supartz FX
Synagis
Synvisc
Synvisc-One
TriVisc
Tysabri
Veletri
Visco-3
VPRIV
Xeomin
Xolair
Yervoy
Zemaira


Quick Links

» Authorization Table
» Submission Status Tracker
» Drug Information
» Education
» Find a Provider or Facility
» Forms
» Medical Policies
» Provider Guide
» WINS

Quick Links

» Claims/Benefits Lookup
» Manage Authorizations
» Authorization Tables
» Drug Information
» Find a Provider or Facility
» Forms
» Medical Policies A-Z
» Provider Guide
» Submission Status Tracker
» WINS - instant updates
FacebookTwitterInstagrampinterestLinked InYou Tube