Effective January 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
- Cardiac surgical procedures
- Medical oncology
- Radiation oncology
Please continue submitting Wellcare (Medicare) prior authorization requests to Evolent through December 31, 2025, regardless of the service dates.
Beginning January 1, 2026, all Wellcare (Medicare) prior authorization requests for the services listed above must be submitted to Wellcare’s secure provider portal.
We encourage you to use Wellcare’s Pre-Auth Needed Tool, to verify prior authorization requirements for specific procedure codes.
You may contact Provider Services at 1-855-538-0454 until December 31, 2025.
After January 1, 2026, contact Iowa’s provider engagement account management team at providerrelations@IowaTotalCare.com.
Thank you for your partnership with Wellcare.
