USA Rx Benefit Card: Common Questions
To help you understand how the GHG Inc. Rx Benefit Card works, we have answered those questions that people most frequently ask about:
Q. How do I use this card?
The most important things to remember are:
- For drugs that are less costly in the U.S. , take your card to any U.S. network pharmacy you choose. You can always check to see if a pharmacy in your area is in the network by searching for the retail pharmacy closest to you just by entering in your zip code.
- For drugs that are less costly from international sources, send your enabling documents to Total Care Pharmacy. These documents can be retrieved from the www.genesishealthgroupinc.com website.
- Your pharmacist can start transmitting all your refills and new prescriptions to the processor for a complete drug record (your profile) that is done for your drug utilization safety checks.
Q. What happens once I present my card at a retail pharmacy that is part of the network?
Once you present your card and prescription to a retail pharmacy that is part of the network, the rest is up to your pharmacist. The pharmacist will ensure your prescription is filled and you are charged a discounted Rx fee as controlled by the network and the processor as well as a $0.95 administration/dispening fee.
Q. How long will it take to receive my original order and refill orders?
If the store is enrolled in the network, all you have to do is show the pharmacist your card and the pharmacist will do the rest. You will see the discounted price on your receipt.
Q. What happens if my local retail pharmacy is not part of the network, can they join?
Yes, if your local retail pharmacy is not a network pharmacy, have your pharmacist call the toll free number on your card. The pharmacist then can immediately arrange to transmit your prescription.
Q. What does “calculated” copay on my card mean?
This means that although you pay the full cost of your prescription directly to the pharmacy, the processor calculates the amount electronically. Your calculated price includes a network discount off the cost of the drug and the pharmacist's dispensing fee. This negotiated “calculated” price is generally much lower than the pharmacy's regular price.
Q. What happens if my local retail pharmacy's advertised price is less than the negotiated network price?
The pharmacist should submit the regular price to the processor. The processor allows only the lower of his regular price or the negotiated price. (It is not uncommon for some stores to advertise "loss leader drugs" - drugs that they are willing to lose money on to encourage customers to come to their pharmacy.) If your drug is advertised at a lower price than the negotiated price the pharmacist should submit the advertised price to the processor. Do not allow yourself to be penalized because your prescription is being processed! Remember - your prescription must be transmitted to the processor so it can perform necessary safety checks against your drug profile.
Q. How can I tell if my prescription has been transmitted?
A prescription that has been electronically processed should have a "Claim Reference Number" printed on your receipt or label. Always check for this number. This way you can be assured that you have received the lowest price and that your medication has been checked against your central profile for interactions or other problems.
Q. What pharmacy can I go to?
This plan recognizes Any Willing Pharmacy Provider. Any pharmacy that agrees to meet the plan's conditions and electronically submit your prescription can fill it for you. Thousands of pharmacies across the USA have already agreed to do this. However, if your personal pharmacy is not a member of this network, the pharmacist can call the toll-free number on your membership card and immediately arrange to process your prescriptions.
Q. What can I do if a pharmacy will not honor my drug card?
Have the pharmacist call the 1-800 number on the back of your card.
Q. Can I transfer my prescriptions to a pharmacy that will honor my card?
Yes! The pharmacist at the store you wish to transfer your prescription to can usually do this for you as long as it is another local U.S. pharmacy.
Q. Why should I get my available brand-name drugs from Genesis Health Group Inc.'s credentialed international provider pharmacies?
There are three primary reasons to order your brand name drugs and even some of your generic drugs from Genesis Health Group Inc.'s credentialed international provider pharmacies. These include:
- Source Accountability
- Centralized profile and important safety checks
- Lower prices for your most costly medications
