We release communications to in-network providers about changes to health plan procedures, policies and benefits, as well as information about larger initiatives. This page lists some of our issued notifications for reference.
Get familiar with a wide range of available programs and services for members and promote them to your patients, when appropriate.
Upcoming changes as we partner with Medica to align best practices and share technology.
Select “Opt-In for Electronic Communications” in your WellFirst Health portal account settings.
We will communicate information about changes related to our partnership with Medica through monthly policy notices, quarterly newsletters and other communications when needed. You'll find all of these linked from this web page.
2023 member plan and benefit highlights for provider awareness.
Issued: November 2022
Audience: All in-network providers
Effective date: 1/1/23
See 2023 changes (PDF)
WellFirst Health is transitioning the Claim Appeals application in the Provider Portal.
Issued: August 2022
Audience: All in-network providers
Effective date: 8/24/22
View new claim appeals portal application (PDF)
Annual notification with member-centered plan and benefit topics for provider awareness for 2022.
Issued: November 2021
Audience: All in-network providers
Effective date: 1/1/22
See 2022 changes (PDF)
FDA approved drugs that are new to the market will not be covered until they are reviewed and approved by P&T Committee.
Issued: September 2021
Audience: All in-network providers
Effective date: 12/1/21
See P&T Committee change (PDF)
Audience: all in-network providers
For pharmacy updates issued on and after April 1, 2022, see the medical and drug policy updates listed on this page.
Audience: All in-network providers
ALDURAZYME-laronidase, ARANESP-darbepoetin alpha, ELAPRASE-idursulfase, ELELYSO-taliglucerase alfa, Epoetin Alfa Products, NAGLAZYME-galsulfase, VIMIZIM-elosulfase, and retired policy (PDF)
Issued: February 2022
Effective date: 6/1/2022
Xeljanz (tofacitinib), Rinvoq (upadacitinib, Benlysta (belimumab, GAZYVA-obinutuzumab, SPINRAZA-nusinersen and retired policies (PDF)
Issued: February 2022
Effective date: 5/1/2022