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Pharmacy Prior Authorization Process Effective June 1, 2020
5/10/2020 • Posted by Provider Relations

WellCare New York members enrolled in Medicaid, Child Health Plus, and Essential Plans products* will transition to and become Fidelis Care members effective June 1, 2020.  These members will be issued a Fidelis Care member identification card; therefore, the transition may be transparent.


Pharmacy Prior Authorizations requests for these plans and transitioned members should be faxed to 1-877-533-2405, which is our same Medicaid fax number.  Please use the existing Medicaid fax authorization form found here:  NYS Medicaid Prior Authorization Request Form For Prescriptions


*Note:  WellCare New York members enrolled in a Managed Long Term Care product are transitioning to Fidelis Care as well effective June 1, 2020; however, they will not be affected by the above pharmacy authorization process.

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Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

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