Direct Member Reimbursement
Request reimbursement for covered medications you paid for out of pocket.
How It Works
If you paid out of pocket for a medication that should have been covered under your pharmacy benefit, you may be eligible for reimbursement. This can happen when your pharmacy doesn't have your coverage on file, or in situations where you needed medication urgently and couldn't use a network pharmacy.
Request Reimbursement
To submit a reimbursement request, download and complete the form below. You'll need to include your pharmacy receipt showing the medication name, date of purchase, and amount paid.