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Get Wellcare Card Example

This form cannot be used to request: ¾ Medicare non-covered drugs, including barbiturates, benzodiazepines, fertility drugs, drugs prescribed for weight loss, weight gain or hair growth, over-the-counter drugs, or prescription vitamins (except prenatal vitamins and fluoride preparations). ¾ Biotech or other specialty drugs for which drug-specific forms are required. See www. WellCare.com OR See links to plan websites at http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/04_Formulary.asp Patien.

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