Do you have prescriptions that you take daily? If you need to find out if your prescription medications are covered by your plan, follow the link below to your Pharmacy Benefits manager.
Fusion Health utilizes multiple pharmacy benefits managers to help our members keep their prescription costs low.
You can find which medications are covered by your plan by clicking on the “Forms” tab and opening the “Drexi OpenRx Formulary.” If your medication is not on the list, you can use the “Prior Authorization” to request that your medication be covered. Please note that there are other forms available if you have additional prescription medication needs.
If your pharmacy benefits are managed through Vivid Clear RX, follow the link to sign up for their member portal.
Create an account with Medimpact to learn more about your benefits, copays, deductibles, and claims status.
Frequently Asked Questions
1. What is a pharmacy benefit manager?
A Pharmacy Benefits Manager (PBM) is like a helpful middleman for your prescription medications. They work behind the scenes to negotiate better prices with drug makers and pharmacies, making sure you get the medications you need at a cost that’s manageable. They also handle the paperwork and ensure that your prescriptions are covered by your insurance plan, so you can focus on feeling better without worrying about extra hassles.
2. What is covered under my prescription drug plan?
Every pharmacy benefits manager has a different prescription drug formulary—a list of drugs that their plan covers. You can review the list of approved medications by visiting the website of your pharmacy benefits manager.
3. What should I do if my medication is not covered?
You may find that your medication is not listed on your pharmacy benefit manager’s formulary. Don’t panic. Your pharmacy benefit manager can pre authorize you to continue using your name brand medication. You will likely need to submit a pre authorization form. You may also be asked to have your doctor submit the form on your behalf.
4. Who can help me if I’m having trouble navigating my prescription drug plan?
You always have an advocate at Aither Health.
