Pharmacy FAQ's

I ordered my drugs through mail service and the post office lost the package. I'm almost out of my prescription. Can I go to my local pharmacy?

The first step you need to take is to report it to Medco. They will initiate a lost order refill. The lost order refill will generally be expedited to you if you are about out of your medication. If it is determined that you will run out before the order is due to arrive, Medco will authorize a 7-day supply to tide you over until your new order is received. You will be responsible for the copayment of the first order and the second order and one of your refills is used to fill the lost order refill.. IMPORTANT: If two weeks go by and you still have not received your initial order, contact Medco again to let them know you never received your initial order and you need them to credit you and the plan. Medco has this in place because some initials do eventually get delivered to the member.

I ordered several medications from mail service and was told by Medco Health that I had to pay for them up-front before they mailed the prescriptions.

If the total amount of your copayments exceed $150, Medco will require the member to pay via credit card or by check before they mail the prescriptions. The account must be kept current or order may be delayed due to past due balances.

I do not want to use my credit card to pay for the drugs I get from mail service, yet I don't know how much to send when I send my order. How am I supposed to get that information?

There are several ways that you can find the amount of your copayment. You can access Medco Health's website, www.medco.com. After registering, you can compare your copays through retail and mail. Keep in mind, however, that if you are on a plan that has a percentage co-insurance, the amounts given as copayments are only estimates. If you do not have internet access, you can also call Medco's Customer Service. They, too, can give you approximate copayments.

My doctor wrote my prescriptions for one quantity, but when it was filled through mail service, Medco filled it for another quantity. If my doctor wrote it for that quantity, why isn't Medco filling it as it was written?

For the safety of the patient, PEHP has implemented a Maximum Day Supply edit on every prescription. If the dosing on the prescription exceeds the manufacturer and FDA recommendations, the quantity will be cut back to comply with those limitations.

My spouse has coverage through another carrier. When I submitted the claims into Medco, they did not pay the copayment in full. I think I should be getting paid for the entire copayment. Why aren't I?

PEHP will pay up to what they would have paid - had they been prime. Therefore, if your primary carrier has a deductible or a high copayment and that amount is greater than what PEHP would pay, PEHP will pay only what they would have paid if that claim had been processed through the PEHP card. Double coverage does not necessarily guarantee that your COB claim will be paid in full.