Pharmacy Benefits

Prescription and over-the-counter (OTC) drug benefits

Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. We work with MedImpact to provide these pharmacy benefits.

Prescription drugs

OTC drugs with a written prescription

Find a pharmacy

To find a pharmacy near you, use our pharmacy locator tool.

Fill a prescription

Bring your member ID card and prescription to a plan pharmacy. A doctor can also call in the prescription for you.

It’s good to use the same pharmacy each time you fill a prescription. This way, your pharmacist will know about problems that may happen when you’re taking more than one prescription. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking.

You can also get other services at MedImpact pharmacies. Don’t wait for an office visit — get these shots and services at the drugstore::

• Flu vaccine
• COVID-19 vaccine
• COVID-19 testing
• Tdap: tetanus, diphtheria, pertussis vaccine
• Gardasil: human papillomavirus vaccine
• Pneumovax 23 and Prevnar 13: pneumococcal pneumonia vaccines
• Zostavax: shingles vaccine

Dose Optimization

The Dose Optimization program can help you follow your medicine routine. You, your prescribing doctor, and a pharmacist work together to replace many doses of lower-strength drugs with one dose of a higher-strength drug. Your prescribing doctor has to approve this change to make sure it’s right for your care.

Prior authorizations (preapprovals)

Some medicines need a preapproval, or an “OK,” from MedImpact before your doctor can order them. The preapproval process helps us make sure that you’re taking drugs safely and the right way.

Here are some reasons that preapproval may be needed:

• There is a generic or pharmacy alternative drug on hand.
• It is for a greater amount of medicine than our standard 30-day supply.
• The drug could be misused or abused.
• There are other drugs that should be tried first.
• The drug has a high side effect that could happen.
• The drug is prescribed at a higher dose than recommended.
• There is more information needed about your health issue so we can match it to the FDA approval of the drug and/or studies of effectiveness.

For medicines that need preapproval, your doctor will need to call 844-336-2676 Monday through Friday from 8 a.m.-7 p.m. MedImpact will review the request and give a decision within 24 hours. If you need your medicine right away, you may be able to get a 72-hour supply while you wait.