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Filing a pharmacy claim

HealthChoice Medicare supplement plans

Usually, your claim is processed electronically at the pharmacy. If your pharmacy has questions, have them contact the HealthChoice SilverScript pharmacy helpline, 7:00 a.m. to 12:00 a.m., 7 days a week including holidays, at:

  • SilverScript Plans toll-free 866-693-4620.
  • Without Part D Plans toll-free 800-364-6331.
  • TTY 711.

In some cases, you may need to pay the full cost of your drug and then ask HealthChoice to repay you for its share. You may need to ask for reimbursement when:

  • You use a non-Network pharmacy.
  • You pay the full cost for a drug because you did not have your plan ID card.
  • Your drug has a restriction and you decide to purchase the drug immediately.

To ask for reimbursement, send your pharmacy receipt and the appropriate prescription claim form linked below to the pharmacy benefit manager at the address on the form.

If your claim involves coordination of benefits with other group insurance, include a copy of the pharmacy receipt that lists your name, the name of the medication, and the amount you paid for the prescription. When your claim is received, the pharmacy benefit manager will let you know if more information is needed.

If your claim is for a covered medication and you followed all plan guidelines, HealthChoice reimburses you for its share of the cost.

If your claim is for a non-covered medication or you did not follow plan guidelines, HealthChoice sends you a letter letting you know the reasons for not sending reimbursement and what your rights are to appeal the decision.