Reimbursement Policy

 

The plan shall determine if a Pharmacy Reimbursement should be granted in response to the written request from a member or their authorized representative. The reimbursement process involves the submission of a pharmacy receipt and the reimbursement request. The plan shall process the request within 14 calendar days. If the decision is favorable, the payment will be issued after 14 calendar days after having received the request.

 

Request

 

To learn how to submit a paper claim, please refer to the paper claims process described in Chapter 9 of your plan’s Evidence of Coverage.

 

Download and complete the following form for pharmacy reimbursement:

 

 

 

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