Frequently Asked Questions

Where can I find details about my pharmacy benefits?

Once you log in to your IngenioRx member account, you can view a summary of your pharmacy benefits including drug-specific pricing and coverage information and a list of in-network retail pharmacies. You can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

How can I find drug-specific cost and coverage information?

Once you log in to your IngenioRx member account, select “Price a Medication” from the menu, enter the drug name, and follow the instructions to view cost and coverage information for your prescription. You can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

How can I find a pharmacy that will accept my prescription coverage?

Once you log in to your IngenioRx member account, select “Find a Pharmacy”, enter the zip code or city name you want to search, and follow the instructions to find a participating retail pharmacy. You can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

If you are having trouble finding an in-network pharmacy that can fill your prescription, you can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

Where can I download forms or a new member ID card?

Once you log in to your IngenioRx member account, select “Access Your ID Card” from the menu and choose your preferred delivery method for your replacement ID card. To download commonly used forms, select “Support” from the top navigation and navigate to “Forms”. There you will find a list of commonly used forms. You can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

Who do I contact if I am having trouble filling a prescription or using my pharmacy benefits?

If you are having trouble filling a prescription or using your pharmacy benefits, you can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

If you have been prescribed a drug that is not covered, your doctor can request a non-formulary drug based on medical necessity. Your doctor can get the process started by calling the Member Services number on the back of your member ID card or by downloading and submitting a request form from our website. If the request is approved, the amount you pay for the drug will depend on your plan’s benefit.

What can I do if I think there was an error in the application of my pharmacy benefit?

Reporting possible errors helps to ensure that you are getting the full value of your pharmacy benefits and allows us to detect other problems. If you suspect an error, you can call us at the pharmacy services number on the back of your ID card to speak with an IngenioRx member services representative 24/7.

If I need an emergency supply of my medication, who do I contact for an exception?

If your medication has been lost/damaged or if you are travelling and need to refill your prescription early, please contact our Member Services team at the pharmacy services number on the back of your ID card to determine whether or not an override of your benefit allowances is available.

How Does IngenioRx Make Decisions about Which Prescription Drugs Require a Prior Authorization?

General information on how we make decisions can be found on our How We Evaluate Care page. Information on specific programs, including prior authorization requests and formulary management, can be found on our Provider Resources page for physicians.