This comprehensive guide explores how Medi-Share members can effectively manage prescription costs at the pharmacy.
The Complete Guide to Managing Prescriptions with Medi-Share
In today's world, health care expenses are a major concern for many people, with prescription medications accounting for a significant portion of these costs. Medi-Share provides an affordable solution, which helps members save up to 50% on their monthly expenses while gaining access to discounted medications.
What you'll learn:
- How prescriptions work with Medi-Share?
- What is Navitus Health Solutions?
- Are prescriptions eligible for sharing?
- How to use Medi-Share at the pharmacy?
- How are prescriptions handled with a Medi-Share 65+ membership?
How Do Prescriptions Work with Medi-Share?
Each Medi-Share member receives an ID card when they join which contains pharmacy information.
This ID card, which can be found in the Medi-Share member center, provides health care professionals with the information they need to search for prescription discounts on a members behalf.
These discounts can be significant and are available to members, through Medi-Share's partnership with Navitus Health Solutions. On average members save up to 91% on generic medications and up to 23% on brand name medications through Navitus.
When filling a prescription, Medi-Share members simply present their ID card at the pharmacy and any available discounts are automatically applied. Any remaining expense after the discount is applied will be paid by the member out-of-pocket.
Members can submit any eligible prescription receipts to Medi-Share, which may count toward their Annual Household Portion (AHP). The AHP is the annual dollar amount a member must meet before sharing can begin. If the AHP has already been met, members can submit eligible prescription receipts for reimbursement. For more information on prescription eligibility, see the section below on ‘What is Eligible for Sharing?’
Navitus provides prescription discounts to members, regardless of whether their AHP has been met or if the medications are ineligible for sharing. This ensures members can still enjoy savings on their prescriptions.
This system reflects Medi-Share's commitment to supporting members beyond basic medical care. By making prescription costs more affordable and easier to navigate, Medi-Share provides peace of mind and helps members take control of their health care expenses.
What is Navitus Health Solutions?
Navitus Health Solutions is a trusted Pharmacy Benefit Manager (PBM) dedicated to helping Medi-Share members access affordable medications with ease. While Navitus doesn’t dispense medicines directly, it connects members to expert care through its vast network of skilled pharmacy professionals, providing personalized support every step of the way.
Navitus has partnered with GoodRx to make prescription medications more affordable for Medi-Share members. This collaboration guarantees members access to the best possible savings by automatically applying the greater discount—whether it comes from Navitus or GoodRx—at checkout. No extra steps are required; simply present your Member ID card to receive the lowest price available.
To further streamline the process Medi-Share members can also access the Navitus member portal, a user-friendly platform designed to simplify managing your prescriptions. With this tool, you can search for medications, compare prices, and locate participating pharmacies, empowering you to make informed, budget-conscious decisions effortlessly. Explore its features below:
- Cost Comparison Tool: Compare prescription costs to find the best possible price.
- Pharmacy Search: Access a nationwide network of participating pharmacies
- Mail-Order Prescriptions: Get a 90-day supply of long-term or ongoing medications through the mail
- Virtual Medicine Cabinet: See a log of your past prescriptions filled through Navitus
- Essential Forms at Your Fingertips: Quickly access pre-notification forms required for specialty medications
- Explore Medications: Easily browse a comprehensive list of preferred and non-preferred medications tailored to various conditions
Members are encouraged to fully utilize these tools to feel confident and informed when visiting the pharmacy. By leveraging these resources, they can make thoughtful decisions that align with their health care needs. Taking charge of their health through informed choices not only leads to better outcomes but also fosters a more positive experience. Remember, advocating for yourself is not only okay—it’s empowering.
To access these features and more, Medi-Share members are encouraged to create an account with Navitus through their member portal. The process is simple and only takes a couple of minutes to complete. Members can follow this guide for step-by-step instructions or watch this video to learn more. A Navitus account is not required to access prescription discounts; it simply serves as an additional resource to help you make informed decisions about your health care and budget.
What is Eligible For Sharing?
Under Medi-Share's guidelines, most prescriptions are eligible for sharing. Prescription medications become eligible for sharing for six months following a new diagnosis, as long as the condition is not pre-existing. Understanding this eligibility is crucial for planning your health care needs effectively.
The six-month sharing period for new conditions allows members to manage their health proactively by offering financial support during the early stages of diagnosis and treatment.
It is important to note that controlled substances and illegal drugs are not eligible for sharing under any circumstances. For a detailed look at which prescriptions are/aren't eligible for sharing visit Medi-Share's guidelines.
By establishing clear guidelines and offering support for new diagnoses, Medi-Share empowers its members to concentrate on recovery and health management, alleviating financial burdens.
How to Use Medi-Share at the Pharmacy
Want to know what a successful visit to the pharmacy looks like as a Medi-Share member? We've outlined the process in the following steps:
- Visit the Navitus member portal and use the search tool to locate a participating pharmacy that meets your medication needs at a price that works for you. With options like Walgreens, Walmart, and Kroger among the many pharmacies accepting Navitus discounts, accessing your prescriptions offers both convenience and affordability.
- Present your Member ID card upon arrival and point out the Navitus partnership listed in the top-right corner. Your card provides instant access to discounted rates through Navitus and GoodRx, ensuring you pay the lowest price at purchase.
- Pay any remaining out-of-pocket costs.
- Retain your receipt and submit eligible prescriptions to Medi-Share using the Prescription Reimbursement Form in your Member Center. Expenses will either apply toward your AHP or, if the AHP has been met, may qualify for reimbursement.
Specialty Medications and Pre-Notification
For prescriptions not available at your pharmacy, the Medi-Share and Navitus partnership provides access to Lumicera Specialty Pharmacy, offering discounted rates on specialty medications.
If you are prescribed medications for complex or rare conditions such as cancer, it is crucial to pre-notify Navitus for any specialty medications you may need. This includes infusions or injections, whether they are administered at home or in a doctor's office. These specialty medications often require special handling, storage, or administration, and pre-notification helps ensure that everything is set up correctly for your treatment. To facilitate seamless coordination of these services and avoid any potential delays in your treatment, members are encouraged to have their provider contact Navitus at 1-833-837-4306 to start the pre-notification process.
Maximize Your Visit With Your Pharmacist
Many people visit their pharmacy every 30 to 90 days to pick up prescription refills, far more frequently than they visit their prescribing provider. This makes pharmacy staff some of the most consistent health care professionals in patients' lives. Pharmacists and their teams are dedicated to providing exceptional care, and their expertise can be a valuable resource for all things related to medications and prescriptions.
Make the most of their professional knowledge by seeking their advice. Not only are pharmacists highly qualified medical professionals, but consulting with them comes without the cost of scheduling an appointment with a specialist.
Pharmacists play a vital role in your health care team and are there to support you. Building a strong relationship with them can simplify future visits and help you navigate your medication needs with ease. To help you make the most of your pharmacy experience, we’ve created several helpful articles:
- 5 Questions to Ask Your Pharmacist
- 5 Things Your Pharmacist Wants You to Know
- 5 Things to Tell Your Pharmacy
By using these resources, you’ll be better prepared to optimize your pharmacy visits, foster meaningful connections with your pharmacy team, and take full advantage of the discounts available to you through Medi-Share.
Medi-Share 65+ and Medicare Part D: What You Need to Know
All Medi-Share 65+ members are strongly encouraged to enroll in Medicare Part D (Medicare Prescription Drug Benefit) to manage their prescription needs effectively. Medicare Part D helps with the cost of your medications, reducing the out-of-pocket expenses that can quickly add up. It’s important to understand that failing to enroll in Medicare Part D when first eligible can result in costly, lifelong penalties. These penalties are added to your monthly Medicare cost and can significantly impact your financial situation over time, making it even more critical to enroll as soon as possible.
Additionally, Medi-Share 65+ memberships do not qualify for any Navitus discounts, which means members are unable to access certain savings on prescriptions directly through Medi-Share. By enrolling in Medicare Part D, you can get help accessing the prescription medications you need without unnecessary financial strain. Taking these simple but important steps can protect both your health and your budget, providing peace of mind and consistent access to vital medications.
Conclusion
With Medi-Share, saving on medications is easier when you take full advantage of the available resources. By utilizing tools like the member portal and partnerships with Navitus and GoodRx, you can take control of your health care costs while ensuring access to the medications you need.
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