Effective Jan. 1, 2026, all Wellcare (Medicare) prior authorization requests will transition from Evolent to Wellcare. This transition is only for Wellcare (Medicare). There is no change to Iowa Total Care (Medicaid) prior authorization processes.
The following Wellcare (Medicare) services will transition from Evolent to Wellcare:
- Advanced/cardiac imaging
- Physical, occupational and speech therapies
- Orthopedic and spine surgeries
- Interventional pain management
- Medical oncology
- Radiation oncology
- Cardiac surgical procedures
As of Jan. 1, 2026, all Wellcare (Medicare) prior authorization requests for the services listed above must be submitted to Wellcare’s secure provider portal. Wellcare encourages the use of its Pre-Auth Needed Tool, to verify prior authorization requirements for specific procedure codes.
For questions or concerns, contact Iowa’s provider engagement account management team at [email protected] or call Provider Services at 1-800-977-7522 (TTY: 711), Monday – Friday, 8:00 a.m. – 8:00 p.m. CT.
View the complete Wellcare Provider Alert here.