HEALTH AND WELLNESS 29 DISCOUNT ONLY—NOT INSURANCE. Discounts are available exclusively through participating pharmacies. The range of the discounts will vary depending on the pharmacy chosen and type of medication. This program does not make payments directly to pharmacies. Members are required to pay for all healthcare services. You may file a complaint by contacting Customer Care at 1-800-700-3957. This program is administered by Medical Security Card Company, LLC (MSC) of Tucson, AZ (a subsidiary of MedImpact Healthcare Systems, Inc.). Some of the therapeutic categories covered by Step Therapy include allergy/nasal antihistamines, osteoporosis, asthma/COPD, migraine, hypertension, and diabetes. To find out if your medication is part of the step therapy program, use the formulary look up tool on the pharmacy page of MySrippsHealthPlan.com or call MedImpact member services at 844-282-5343 (HMO option) or 800-788-2949 (EPO option). How It Works When filling your prescription, the pharmacist runs the prescription through the system and is alerted of the step therapy program requirement. If your six month history shows that the first line drug was previously dispensed, then the second line or higher cost medication can be dispensed. However, if there is no record of a first line drug being dispensed previously, then you must try the first line drug first or go through the prior authorization process. Prior authorization is a process where the doctor submits a medication request form stating the reason why the patient must have the second line drug filled at the pharmacy without going through the step therapy process. Prescription Drug Tools and Resources Visit the pharmacy page of MyScrippsHealthPlan.com for information about your pharmacy benefits, including access to the formulary/preferred drug listing, pharmacy locator, and mail service registration. You can also call MedImpact with questions about your pharmacy benefits at 844-282-5343 (HMO option) or 800-788-2949 (EPO option). Save Money on Prescriptions Not Covered by Your Medical Plan As part of your prescription drug benefit, you automatically participate in the iRx Program™ which allows you to save money on prescription drugs not covered under Scripps Medical Plan. On average, you can save 45 percent (with potential savings as high as 80 percent)* when you use a participating pharmacy for a drug that qualifies for a discount. More than 60,000 participating pharmacies accept the iRx Program, including most participating MedImpact pharmacies. * On average, Scripps members saved 36.4% per iRx prescription. Based on actual 2022 Scripps membership utilization. How It Works • Present your prescription and your Scripps Medical Plan ID card at a participating pharmacy. • Savings are automatically applied when the medication prescribed is not covered under Scripps Medical Plan and qualifies for a discount. • Prescriptions that qualify for a discount through the iRx Program are automatically cross-referenced with your other prescriptions to check for safety issues, such as drug interactions. • There are no limits on the number of times the program can be used. • You are automatically enrolled as part of your Scripps Medical Plan coverage, and you pay no separate enrollment or maintenance fees. Visit the pharmacy page of MyScrippsHealthPlan.com for more information about the iRx Program, including how to find participating pharmacies.
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