Maine.gov

MaineCare PDL

Health Care for Maine People

Pharmacy

Provider Help Desk: (p) 888-420-9711 (f) 800-408-1088 | Member Help Desk: (p) 866-796-2463 (f) 207-287-8601
Prior Authorization (PA) Helpdesk (for Provider PA inquiries): (p) 888-445-0497 (f) 888-879-6938

Wellcare

Name Description Date
Medicare DER Form 73.57 KB 2007/04/03
Injectible 64.53 KB 2007/04/03
Model Coverage Determination Request Form 243.43 KB 2007/04/03
Redetermination 246.47 KB 2007/04/03
PDP Appeal Request 31 KB 2007/04/03