HealthChoice Medicare Supplement Plans
Filing a Pharmacy Claim
Usually, your claim is processed electronically at the pharmacy. If your pharmacy has questions, have them contact the Express Scripts Pharmacy Help Line, 24 hours a day, 7 days a week including holidays, at:
- Toll-free 1-800-922-1557
- TTY/TDD users call toll-free 1-800-825-1230
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:
- You use a non-Network pharmacy
- You pay the full cost for a drug because you did not have your plan ID card
- Your drug has a restriction and you decide to purchase the drug immediately
To ask for reimbursement, send your pharmacy receipt and Coordination of Benefits/Direct Claim Form to:
|Without Part D Plans:
||With Part D Plans:
PO Box 14711
Lexington, KY 40512
ATTN: Medicare Part –D
P.O. Box 2858
Clinton, IA, 52733-2858
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 Express Scripts, 24 hours a day, 7 days a week, at:
- With Part D call toll-free 1-800-590-6828 or toll-free TDD 1-800-716-3231
- Without Part D call toll-free 1-800-903-8113 or toll-free TDD 1-800-825-1230
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, Express Scripts 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.