Out of Network Coverage

We pay for drugs filled at an out-of-network pharmacy, only when you are not able to use a network pharmacy.  We have network pharmacies outside of our service area where you can get your prescriptions filled as a member of our plan. We will pay for your drugs filled at an out-of-network pharmacy in the following cases:

  • When you are out of the area, require a prescription filled unexpectedly, and are unable to obtain medication at a network pharmacy
  • During a declared disaster in your service area. If you cannot use a network pharmacy during a declared disaster, you will be able to fill your prescription drugs at an out-of-network pharmacy.
  • 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 1-844-239-7387. Hours are from 8 a.m. to 8 p.m., seven days a week. TTY users call 711. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day.

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 when you fill your prescription. You can ask us to pay you back for our share of the cost.