Important 2023 Part D Coverage Information

Date: 01/20/23

Providers play an important role in helping our Wellcare By Allwell (Medicare) members stay healthy. As part of the Inflation Reduction Act (IRA) passed by Congress, there are new updates in Part D coverage to adult vaccines and insulin.

Vaccine Coverage

Adult vaccines covered by Part D and recommended by the Advisory Committee on Immunization Practices (ACIP) will be available at $0. Wellcare members will not be responsible for an administrative fee. To improve vaccine access and member experience, providers should discuss any upfront charges with patients prior to administering Part D vaccines. This ensures that patients are aware of what they would need to pay out of pocket for the vaccine and are then able to seek reimbursement from their health plan.

Insulin Coverage

Additionally, as part of the IRA, Wellcare members will not pay more than $35 for a one-month supply of each insulin product they take. The insulin product must be covered by their Medicare prescription drug plan and must be dispensed by either a local or mail-order pharmacy. The $35 cap applies to all coverage phases in all Medicare plans. All members are eligible, including those who receive “Extra Help.”

For more detailed information about these Part D coverage changes, please reference:

• 2023 Part D Immunizations (PDF)
• 2023 Part D Coverage of Insulin (PDF)

For any questions regarding these updates, please contact SHP_PharmacyMedicare@Centene.com.