How can I get reimbursed for pharmacy expenses?
Ultimately, the best source for finding how to get a pharmacy expense reimbursed will be your carrier. However, we have compiled some helpful tips for you below.
Reimbursements for pharmacy expenses within 30 days
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Claims filed within 30 days of the prescription being filled can be directly reimbursed through the pharmacy where the prescription was filled/purchased.
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The plan member will need to present their carrier ID card and a receipt showing the amount they originally paid.
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The pharmacy can then run the claim for the prescription through the carrier's pharmacy claim system and provide a reimbursement for any costs that were previously paid out of pocket.
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Reimbursements do not include copay amounts.
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Some pharmacies will allow direct reimbursements for up to 90 days, but 30 is a good rule of thumb.
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Reimbursements for pharmacy expenses after 30 days
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If the 30-day direct reimbursement period has passed or the pharmacy will not honor the receipt, the plan member would need to submit a claim form through their carrier's pharmacy vendor.
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These claim forms can be obtained on the carrier's website, which you can find the Overview page in the Medical, Dental, or Vision Insuranc card.
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Reimbursement through the carrier typically takes 30 days.
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The carrier will issue payment directly to the member.
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