Prescription Drug Coverage
All members enrolled in a [Plan Name] will automatically have prescription coverage through Company.
Quick Links:
Included in the portal is the Drug Lookup Tool that can help you find the pharmacy (online and retail) where you can get your medications at the best price.
How do I get my prescriptions at the pharmacy?
Provide your prescription benefits card to your pharmacy and ask them to update your insurance profile. The pharmacy will need the BIN, PCN, Member ID, and Rx Group number to process any covered prescription(s)
Which pharmacies can I go to? Is my local pharmacy in-network?
There are over 75,000 in-network retail pharmacies. For specific in-network pharmacy questions or to check whether your local pharmacy is in-network.
Who is my mail-order service provider?
Company*
Where do I get my specialty medications?
The Program is designed to help members secure access to specialty medications through Patient Assistance Programs. A specialty medication is a medication that treats complex medical conditions such as cancer, psoriatic arthritis, and multiple sclerosis, and often require specific handling and storage requirements. All specialty medications require a prior authorization once the member engages Program.
While your patient assistance application is in process, you may be eligible to receive your medication through a bridge fill. A bridge fill is a fill of your specialty medication through your prescription drug coverage administered by Program. Prior to receiving your bridge fill, a medical necessity review may need to be completed.
What is a formulary and where can I find the drug formulary?
A formulary is a list of drugs that your doctor may prescribe for you that includes information related to coverage and cost of these drugs. This list may change over time. You can access your drug formulary by visiting the website. The portal shows what tier a medication is on and indicates if a medication requires a prior authorization or is subject to any other edits such as step therapy, etc.
The Program can help lower your prescription drug costs:
- The program works with preferred pharmacy partners to capture a variety of savings opportunities. Program through Program can help you navigate alternative sources and support for Specialty Medications. This saves you money as many of these programs require little to no co-payment on medications
Where To Go For Care:
When you’re feeling sick or are injured, there are several places you can go for medical care:
- a doctor’s office
- an urgent care center
- a retail health clinic
- the emergency room
Your primary care doctor should be your first call in non-emergency situations. Your doctor knows you and your health history, including what medications you are taking and what chronic conditions might need to be considered in your treatment. Plus, the co-pay for a visit to your doctor’s office will cost far less than a trip to the emergency room.
If you can’t reach your doctor or need care outside of regular office hours, urgent care centers and retail health clinics are good options. Retail health clinics are walk-in clinics found in many large pharmacies and retail stores. They are staffed by nurse practitioners and physician assistants and are designed to treat simple conditions, like cold and flu, ear infections and skin conditions. Telemedicine is another great alternative.
Emergency rooms are designed to treat urgent, acute and life threatening conditions and aren’t the place for routine care or minor ailments. If you feel you are dealing with a health emergency, call 911 or go to the emergency room right away.
TeleHealth Services
Teladoc Health's mission is to empower all people everywhere to live their healthiest lives. From Primary Care to Mental Health and Specialty Wellness and beyond, Teladoc Health puts your healthcare experience at your fingertips!
To get started, simply set up your account online.
- To register for a Telehealth services. (Note: Telehealth system will recognize you when you enter your information to register.)
- If you have already registered for an account, you can sign in
- Need help getting started or have questions about your healthcare? No problem! Telehealth the team is available 24/7 at Phone Number.
- Additional support to get started can also be found here.