Out of Network Coverage

We normally do not cover drugs filled at an out-of-network pharmacy.  We have network pharmacies outside of our service areas. When you are not able to use a network pharmacy we will pay for your drug in the following cases:

  • When you are out of the area, require a drug to be filled unexpectedly, and are unable to obtain your drugs at a network pharmacy.
  • During a declared disaster in your service area and you cannot use a network pharmacy.
  • Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available, up to a 30-day supply.

You can use our Find a Doctor or Pharmacy tool to help you locate a pharmacy that is in our network.

If you have any questions, call Member Services at 1-866-549-8289. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711.

Will the plan pay you back for a prescription?

If you must use an out-of-network pharmacy, you will have to pay the full cost instead of your share of the cost when you fill your drug. You can ask us to pay you back for our share of the cost.

Last Updated: 09/30/2017
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