Members

Members

We believe members have a right to resources and clear answers on their benefits and claims.

Members who are engaged and supported will make the most effective choices for their care and treatment.

Have a question?

Frequently
Asked
Questions

  • Price, safety and effectiveness.

    The average cost of a generic drug is 80% or more less than the brand name alternative, and generic drugs are equally as safe and effective as brand name medications since both are regulated by the Food & Drug Administration (FDA).

    When it comes down to it, the only differences between generic and brand drugs are the inactive ingredients (such as colors or flavors). Generic medications are safe, effective, and save money for both you and the health plan!

  • You should never hesitate and you should always feel comfortable asking your provider any questions you have regarding your treatment plan. It is important to understand risks and benefits associated with your medications and options available to you.

  • A PA is a prior authorization. Some medicines require a prior authorization before a pharmacy can dispense them.

    If your medication requires a prior authorization, contact the Care Team at Prescription Network at 800.279.3022. The Care Team will evaluate if your medication is eligible for prior authorization consideration and reach out to your provider to begin the process of obtaining the necessary documentation for review.

  • Step therapy is a managed care approach to prescription medicines intended to control the costs and risks posed by prescription drugs.

    Patients new to a drug therapy start with lower-priced generic medications since generics are safe, effective and will save money for the patient. If, for any reason, the initial treatment is not successful, the patient can “step” through additional medications to find the drug therapy that works best for them.

  • If for some reason you paid for your medication in full at the pharmacy (for example, you did not have your ID card with you), you may be eligible for reimbursement up to the appropriate out of pocket you would have been charged.

    To submit your claim for reimbursement, click here and fill out our Direct Member Reimbursement form. Prior to submitting the form, be sure to include a copy of your pharmacy receipt. The pharmacy receipt is the detailed medication receipt you received from the pharmacy (NOT the cash register receipt) and is required for your reimbursement to be processed.