There may be times when you pay for your medicine. AmeriHealth Mercy may reimburse you, if you are eligible to receive the medicine at the time you paid for it. This reimbursement process does not apply to co-payments.
Generally, reimbursement is NOT made for medicines that:
- Require prior authorization
- Are not covered by either AmeriHealth Mercy or the Pennsylvania Medical Assistance Program
- Are not medically necessary
- Go over certain dose and supply limits set by the FDA
- Are re-filled too soon
To request reimbursement for medicines you paid for:
Your request for a refund must be in writing. You must send a detailed pharmacy receipt that includes:
- Date you bought the medicine
- Member's name
- Drug store name, address (city, state, zip code) and phone number
- Name, strength and quantity of medicine
- NDC number of medicine (if you are not sure about this information, ask the pharmacist to help you)
- Total amount you paid for each medicine
Write your name, address, phone number, and AmeriHealth Mercy ID number on your receipt or another piece of paper. Send the above information to:
Pharmacy Department
AmeriHealth Mercy Health Plan
200 Stevens Drive
Philadelphia, PA 19113
It may take six to eight weeks before you receive payment.
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