Out-of-Network Pharmacies

We have thousands of pharmacies in our nationwide network to make it easy to get your drugs. We know there may be times when you can't use a network pharmacy. We may cover prescriptions filled at an out-of-network pharmacy:

• If you do not receive more than a 30-day supply, and
• If there is no network pharmacy that is close to you and open, or
• If you need a drug that you can’t get at a network pharmacy close to you, or
• If you need a drug for emergency or urgent medical care, or
• If you must leave your home due to a federal disaster or other public health emergency.

Always contact Member Services first to see if there is a network pharmacy close to you.

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

How do you ask us to pay you back?

1. Complete the Prescription Claim Form - English (PDF) | Prescription Claim Form - Spanish (PDF).
2. Attach the original prescription receipt to the form. If you do not have the original receipt, you can ask your pharmacy for a printout. Do not use cash register receipts.
3. Mail the completed form and receipt to the address on the form. 

After we receive your request, we will mail our decision (determination) with a reimbursement check (if applicable) within 14 days. For specific information about drug coverage, refer to your Member Handbook or contact Member Services. We are here to help.

We have thousands of pharmacies in our nationwide network to make it easy to get your drugs. We know there may be times when you can't use a network pharmacy. We may cover prescriptions filled at an out-of-network pharmacy:

• If you do not receive more than a 30-day supply, and
• If there is no network pharmacy that is close to you and open, or
• If you need a drug that you can’t get at a network pharmacy close to you, or
• If you need a drug for emergency or urgent medical care, or
• If you must leave your home due to a federal disaster or other public health emergency.

Always contact Member Services first to see if there is a network pharmacy close to you.

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

How do you ask us to pay you back?

1. Complete the Prescription Claim Form - English (PDF) | Prescription Claim Form - Spanish (PDF)
2. Attach the original prescription receipt to the form. If you do not have the original receipt, you can ask your pharmacy for a printout. Do not use cash register receipts.
3. Mail the completed form and receipt to the address on the form. 

After we receive your request, we will mail our decision (determination) with a reimbursement check (if applicable) within 14 days. For specific information about drug coverage, refer to your Member Handbook or contact Member Services. We are here to help.