Pharmacy Forms | Allwell from PA Health and Wellness

Pharmacy Forms & Notices


Here’s a list of pharmacy documents and forms you may need when using your Medicare Part D benefit. If you have questions about these items, please contact Member Services. We’re here to help.

This is the complete list of prescription drugs covered by Alwell.

Please select the document for your plan:

Updated 12/01/2020:

If you have questions, please contact Member Services.