Submitting Prescription Drug Claims

Prescription drugs are covered under the Basic, Comprehensive and Premier plans. How you submit your prescription drug claims is based on which plan you have.

Plans Without the Enhanced Prescription Drug Benefit

If Your Plan Has a Drug Card

Your prescription drug claims are settled right in the pharmacy with your Assure Card^®.

When you purchase a prescription drug:

Present your Assure Card to your pharmacist.
Your pharmacist will use the card to verify your eligibility and drug coverage, and to apply any deductibles or coverage limits.
You pay only for fees not covered by PlanDirect, and receive a printed explanation of benefits.

You do not have to fill out any claim forms or wait for reimbursement. It's all handled on the spot.

The Assure Card is recognized by more than 7,500 pharmacies nationwide. If you can't use your Assure Card, complete a Healthcare Expenses Statement.

If Your Plan Does not Have a Drug Card

If your plan does not have a drug card and you have not purchased the Enhanced Prescription Drug Benefit:

1. Complete the Healthcare Expenses Statement for all prescription drug claims.

2. Mail the completed form and original receipts to the Individual Health Unit.

Plans With the Enhanced Prescription Drug Benefit

If Your Plan Has a Drug Card

Your prescription drug claims under your selected PlanDirect plan are settled right in the pharmacy first with your Assure Card.

When you purchase a prescription drug:

Present your Assure Card to your pharmacist.
Your pharmacist will use the card to verify your eligibility and drug coverage, and to apply any deductibles or coverage limits.
You pay only for fees not covered by PlanDirect, and receive a printed explanation of benefits.

The Assure Card is recognized by more than 7,500 pharmacies nationwide. If you can't use your Assure Card, complete a Healthcare Expenses Statement.

Once you have reached the maximum benefit amount for prescription drugs under your selected PlanDirect plan, stop using your Assure Card. Instead, submit your claims under the Enhanced Prescription Drug Benefit:

1. Complete the Healthcare Expenses Statement.

2. Mail the completed form and original receipts to the Individual Health Unit.

If Your Plan Does not Have a Drug Card

If your don’t have a drug card and you have purchased the Enhanced Prescription Drug Benefit:

1. Complete the Healthcare Expenses Statement for all prescription drug claims.

2. Mail the completed form and original receipts to the Individual Health Unit.

Direct Deposit

You can now sign up for direct deposit of your claims payments.

Contact Us

For questions about your policy or to change your coverage or personal information, contact PDAdmin Group.

For questions about claims, contact our Individual Health Unit.