Welcome providers!

Please call the dedicated number on the back of the member's prescription ID card.

In Network Pharmacy Finder

Please use the pharmacy finder specific for the plan. You can find the plan under the Members link at the top.

Step Therapy

Specialty Drug List

Specialty medications are only dispensed through WellDyne Specialty Pharmacy. Atlantic City Plan participants may also obtain specialty medications from UNITE HERE HEALTH Health Center Pharmacy.

All specialty medications undergo prior authorization review, please submit a review request first and then submit a prescription to WellDyne Specialty Pharmacy (or UNITE HERE HEALTH Health Center Pharmacy for Atlantic City participants).

WellDyne Specialty Pharmacy

• To send a prescription for specialty medication to WellDyne Specialty Pharmacy, please call WellDyne Specialty Pharmacy at (800) 373-1879.

Specialty Drug List – review which drugs may only be dispensed by our exclusive specialty pharmacy providers.

UNITE HERE HEALTH Health Center Pharmacy

• To send a prescription to UNITE HERE HEALTH Pharmacy:
  • ELECTRONICALLY: We are listed as the “ Unite Here Health Pharmacy.” Our address 1801 Atlantic Ave 3^rd Floor, Atlantic City NJ 08401. You can locate us in the system using the ID number- “ 3148524 ”
  • BY PHONE: Call (609) 441-7190. Dial 1,1,0 to reach the pharmacist
  • BY VOICEMAIL: Call (609) 441-7190. Dial 1,1,1 for the voice mailbox
  • BY FAX: Our fax number is (609) 441-7196

Mail Order Pharmacy

Mail order service is provided by Welldyne Prescription Service.   To send a prescription electronically, please select WelldyneRx Prescription Delivery in your EMR or you may fax your prescription to: (888) 830-3608 or (877) 221-1259

Mail order prescription form

Prior authorization for pharmacy drugs

Medications that are reviewed for prior authorization or have quantity limits are indicated on the respective formularies.

• To request a Prior authorization review, please fill out this PA request form and fax to please fax prior authorization request to Hospitality Rx Clinical Department at 877-245-0875.

Prior Authorization Initiation Form

Formulary Exception Form

Use this form to request an exception to the formulary, including for contraceptives not on the formulary.

Formulary exception form