Usually, your claim is processed electronically at the pharmacy. If your pharmacy has questions, have them contact the Medco Pharmacy Help Line, 24 hours a day, 7 days a week including holidays, at:
In some cases, you may need to pay the full cost of your drug and then ask HealthChoice to repay you for its share. You may need to ask for reimbursement when:
To ask for reimbursement, send your pharmacy receipt and Coordination of Benefits/Direct Claim Form to:
| Without Part D Plans: | With Part D Plans: | |
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Medco |
Medco |
While you don’t have to use a Coordination of Benefits/Direct Claim Form, it is helpful. You can access a form from the above link or by calling Medco, 24 hours a day, 7 days a week, at:
If your claim involves other group health insurance, include a copy of the Explanation of Benefits statement you received from your other plan. When your request for payment is received, Medco will let you know if more information is needed to process your claim.
If your claim is for a covered medication and you followed all Plan guidelines, HealthChoice reimburses you for its share of the cost.
If your claim is for a non-covered medication or you did not follow Plan guidelines, HealthChoice sends you a letter letting you know the reasons for not sending reimbursement and what your rights are to appeal the decision.