How to fill a temporary supply

New and current plan members:

  • Go to your in-network pharmacy with your prescription. You will get up to a 30-day supply, unless the prescription is written for less.
  • If your prescription is for less than a 30-day supply, you may be eligible to get more fills any time during your 90-day transition period (the first 90 days of your enrollment in our plan) until you have filled 30 days worth of your medication. This period begins with your effective date of coverage, whether you are a new or current member.
  • We will send you information about your temporary fill within three business days of filling your prescription. You'll get a written notice explaining a few important things.
    • You will be told that your prescription was temporarily filled and why.
    • You will be told how to work with us and your provider to find an appropriate alternative on our formulary. 
    • You will get information about your right to request a coverage determination or an exception, as well as the process for requesting a coverage determination or an exception.

Members in long-term care facilities:

If you are a resident of a long-term care facility, your facility will fill your prescription. You will get up to a 31-day supply, unless the prescription is written for less. You are eligible to get multiple refills as needed, up to a 93-day supply during the first 90 days of your admission to the long-term care facility.

We will also send you information about your temporary fill. Within three business days of filling your prescription, you will get a written notice explaining a few important things. You will be told that your prescription was temporarily filled and why. You will be told how to work with us and your provider to find an appropriate alternative on our formulary. And you will get information about your right to request a coverage determination or an exception, as well as the process for requesting a coverage determination or an exception.

After this 90-day period ends, our transition policy provides for a 31-day emergency supply while you or your long-term care facility are asking for a coverage determination or an exception.