Pharmacy
Prescription medicine coverage is part of your Added Choice plan. Where you choose to have your prescriptions filled will determine how much you pay for your medicines. You have three pharmacy options: Kaiser Permanente pharmacies, Participating (community network) pharmacies, and out-of-network pharmacies. Depending on what your plan your employer has selected, you may or may not have out-of-network pharmacy coverage.
You can choose any pharmacy option regardless of your provider option.
Kaiser Permanente Pharmacies
Prescriptions through Kaiser Permanente pharmacies.
You can fill prescriptions (written by any provider) at pharmacies located in Kaiser Permanente medical centers. You will always pay the lowest out-of-pocket costs at these pharmacies. Choose how to fill your prescriptions:
- At Kaiser Permanente medical centers. Most Kaiser Permanente medical centers across the region have pharmacies. Kaiser Permanente doctors can send most prescriptions electronically to the pharmacy—or you can present your prescription with your ID card.
- Online. Register at kp.org/register to order most refills online and have the medicine mailed to you.
- Through the refill phone line. Call us at 1-800-700-1479 (TTY 711), 24 hours a day, and have the medicine mailed to you or available for pick up at any medical center.*
To choose the Kaiser Permanente pharmacy where you’d like to pick up your prescription, visit kp.org/facilities.
*A program operated or arranged by health plan that distributes prescription drugs to members via mail. Some medications are not eligible for the Mail Service Delivery Program. These may include, but are not limited to, drugs that are time or temperature sensitive, drugs that cannot legally be sent by U.S. mail, and drugs that require professional administration or observation. Unfortunately, at this time, we cannot deliver to an address outside the Mid-Atlantic States service area.
Participating (community network) Pharmacies
Prescriptions through participating retail pharmacies.
- Fill prescriptions at participating pharmacies that include Giant, Harris Teeter, Rite Aid, Safeway, Target, Walmart, and others.
- There is no mail-order service with this pharmacy option.
- You may have higher copayments than you would if you go to a Kaiser Permanente pharmacy, and a deductible may apply, depending on your plan’s benefits.
Not all locations in a chain participate, some are independently contracted. To check on a specific pharmacy or for more information, call MedImpact Customer Service at 800-788-2949 at any time or check the MedImpact Participating Pharmacy Directory.
Out-of-Network Pharmacies
Depending on what your plan your employer has selected, you may or may not have out-of-network pharmacy coverage. For more information, call Customer Service, Monday through Friday, 7:30 a.m. to 9 p.m., Eastern time, at 1-888-225-7202 (TTY 711).
Fill your prescription (written by any provider) at any pharmacy.
- Fill prescriptions at all other licensed pharmacies.
- There is no mail-order service with this pharmacy option.
- You may have higher copayments than you would if you go to a participating (community network) pharmacy or a Kaiser Permanente pharmacy, and a deductible may apply, depending on your plan’s benefits.
- You may need to pay full out-of-pocket costs for prescriptions filled at out-of-network pharmacies and submit claims for reimbursement.
Finding out what drugs are covered.
- Visit the Mid-Atlantic States Formulary for a list of approved drugs.
Pharmacy Claims Address:
National Claims Administration Mid-Atlantic States
P.O.Box 371860
Denver, CO 80237-9998
How to save money on prescriptions.
- Fill prescriptions from Kaiser Permanente doctors, affiliated doctors, out-of-network doctors, and dentists at Kaiser Permanente medical center pharmacies, where you’ll usually pay the lowest copay.
- Just bring your prescription and your ID card to the medical center. To find medical centers, go to kp.org/facilities.
- If you are registered at kp.org, you’ll be able to order refills online or by phone and have them delivered, with no cost for postage (applies to most drugs).
Finding out what drugs are covered.
- To find out if your prescription medications are on the plan drug formulary you can visit the Mid-Atlantic States Formulary for a list of approved drugs.