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 and are unable to obtain your medication 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.

Call Member Services at 1-866-896-1844 to see if there is a network pharmacy nearby. Hours are from 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on 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 generally have to pay the full cost instead of a copay when you fill your prescription. You can ask us to pay you back for our share of the cost.


Last Updated: 10/01/2016
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