If you are eligible for pharmacy reimbursement, follow the steps below to receive reimbursement for a prescription.
- Complete the Direct Member Reimbursement Form. Be sure to include your member ID number on this request. This number is located on your Member ID card.
- Be sure to send the prescription (the piece of paper that was stapled to the bag).
- Mail the request and prescription receipt to:
Pharmacy Authorization Coordinators
Optima Health
4417 Corporation Lane
Virginia Beach, VA 23462
- Plan members will be reimbursed allowable charges less the applicable copay. This applies to Point-of-Service (POS) and PPO members. HMO members may be reimbursed, but only in emergency situations.
All requests for pharmacy reimbursement are subject to plan guidelines, policies and procedures. For example, if a drug requires pre-authorization and has rejected at the pharmacy, it is not eligible for reimbursement.