Here you will find tools and resources to help you better manage your pharmacy benefits.
Maximize Your Pharmacy Benefits
Understand Your Plan
Learn about your copays, deductibles and benefits of your prescription plan.
Learn More about Mail Order
Mail order is an easy and convenient way to receive your prescriptions, wherever you are.
Learn about Specialty Rx
Learn more about specialty medications and how they are managed for your safety.
Member Resources: Forms and Documents
Designation of Authorized Party Forms
Select the link below to download the Designation of Authorized Party Form in your preferred language:
- Click here to download the HIPAA Consent Form
- Click here to download the HIPAA Release Form
- Click here to download the HIPAA Revoke Form
Prescription Request Form
- Click here to download the Prescription Request Form
- Click here to download the Prescription Request Form Spanish
You may be able to complete your reimbursement request in your Member Portal account. To learn more, log in to your Member Portal account.
- Member Reimbursement Form
- Member Reimbursement Form Spanish
- Member Reimbursement Form for BIN 800004
- Guide to Requesting Reimbursement for OTC COVID-19 Tests
Facts about Generics
- Click here to download the Facts about Generics flyer in English.
- Click here to download the Facts about Generics flyer in Spanish.
Your Rights and Responsibilities
Proper Medication Disposal and Handling
Download tips on proper medication disposal and handling.