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Wellmark Quantity Limits Program |
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The following drugs have a quantity limit: |
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May also require Prior Authorization Wellmark typically covers a 30-day supply for prescriptions. Some drugs, however, have a quantity limit. Amounts over the specified quantity limits are not a covered benefit. Quantity limits are in place to ensure the medication is being used correctly and other treatments are not appropriate. Most people would not need to take these drugs more often than what Wellmark allows. No special steps are necessary by the physician or member to have these drugs covered as long as the medications prescribed do not exceed quantity limits. A few drugs may also require prior authorization (for example, Viagra). If you require one of these drugs in a larger quantity than is allowed, your physician may make a special request for coverage. Your physician may be asked to provide details about your medical condition and treatment plan. After reviewing the information, coverage will be evaluated based on medical necessity. Your benefits certificate, coverage manual, or policy has specific information about your plan’s prior authorization requirements. |
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Wellmark, Inc. All Rights Reserved. Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. |
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