Benefits Plans - Prescription Drug Plan: Pharmacy Network

Page last updated: Monday, 01-Oct-2012 12:03:08 EDT

MedImpact provides a network of over 48,000 available pharmacies in the U.S., and over 2,100 located in Michigan. You can have your prescriptions filled at any network pharmacy by showing your prescription drug plan ID card to the pharmacist. The pharmacist electronically sends your ID number and prescription details to MedImpact and receives back:

  • Verification of your participation as a U-M member in the drug plan.
  • The co-pay or co-insurance amount you need to pay for your prescription.
  • The discounted amount MedImpact pays for the prescription plus the dispensing fee to the pharmacist.
  • Any electronic safety edits or warnings the pharmacist needs to know, or when the pharmacist needs to contact your physician about your prescription.

The University of Michigan custom network includes over 95% of the pharmacies in Michigan, including most major pharmacy chains. The University of Michigan Health Services Pharmacy, University of Michigan Ambulatory Care Pharmacy (in the Taubman Center), the Cancer Geriatric Center Pharmacy (in the CGC), and the East Ann Arbor Health Center Pharmacy participate in the MedImpact pharmacy network. A state and national pharmacy locator of participating pharmacies can be found at: https://mp.medimpact.com/umhor by calling the MedImpact Member Service toll-free number: 1-800-681-9578. Telecommunications Relay Service (TRS) is available for persons who are deaf by dialing 711.

You do not have to file claim forms or wait for reimbursement when you use your MedImpact University of Michigan prescription drug ID card a participating network pharmacy.

Finding a Network Pharmacy

There are a number of ways to find out if a pharmacy will accept your MedImpact ID card.

To find a participating pharmacy anywhere in the U.S.:

  • Review the Pharmacy Locator on the MedImpact website for U-M members at: https://mp.medimpact.com/umh , or
  • Call the MedImpact Member Service toll-free number: 1-800-681-9578
  • To determine if a specific pharmacy participates in the MedImpact Network:
    • Call MedImpact Member Service at 1-800-681-9578 , or
    • Call the pharmacy directly.

If the pharmacy you use is not in the MedImpact network, contact MedImpact and ask to have your pharmacy added to the network.

Retail Pharmacy Benefit

When you present your MedImpact ID card at a participating pharmacy, the pharmacist will be able to tell you the amount of your share of the cost for each prescription. You are eligible to receive up to a 90-day supply for each prescription obtained at a participating retail pharmacy. To receive 90-day supplies of maintenance medications mailed to your home at a discount over retail, consider using NoviXus Pharmacy Service for mail order.

Using Non-Network Pharmacies

If you have your prescription filled at a pharmacy that does not participate in the MedImpact network, you will have to pay the full cost of the drug and file a claim with MedImpact for reimbursement. Claims must be filed within 90 days of fill. Older claims will not be reimbursed. Non-network reimbursement is limited to a 34-day supply. You will be reimbursed based on the contracted price that a participating pharmacy would charge for the same drug, minus your co-pay amount. The plan will not reimburse costs exceeding the contracted price. This reimbursement process also applies if you do not present your MedImpact ID card when you have your prescription filled at a participating pharmacy.

Reimbursement claim forms are available from the Forms page. Or contact MedImpact Member Service at 1-800-681-9578 to request a form.

Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.