Pharmacy
Prescription medicine coverage is part of your HMO Plus or DHMO Plus 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 (Option 1), MedImpact Network-Community Pharmacies (Option 2), or Out-of-Network Pharmacies (Option 3). You can choose any pharmacy option regardless of your HMO/DHMO Plus 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 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.
MedImpact Network-Community Pharmacies
Prescriptions through participating retail pharmacies
Kaiser Permanente works with MedImpact to fill your outpatient prescription drugs at retail pharmacies across the country. You can use any of the over 70,000 retail pharmacies nationwide in the MedImpact participating pharmacy network.
You can fill prescriptions at any participating MedImpact pharmacy. Here’s a partial list:
- Costco
- Rite Aid
- CVS
- Safeway
- Farm Fresh
- Shoppers Food Warehouse
- Giant
- Target
- Harris Teeter
- Walgreens
- Kmart
- Walmart
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
- You have 5 prescriptions you can fill at a pharmacy outside the Kaiser Permanente and MedImpact Networks.
- You may need to pay for prescriptions filled at out-of-network pharmacies in full, and then submit your receipt and copy of the portion of the prescription label that contains the drug name/prescription information to the address below for reimbursement. Once we receive the documentation, you’ll be reimbursed for the cost of the drug, minus your out-of-network benefit cost share.
- You will likely pay less if your physician refers to our formulary when prescribing a drug. To check if a medication is on the Kaiser Permanente formulary, go to kp.org/formulary, choose your region, and select the HMO Formulary link.
- Your out-of-network provider can determine if a particular medication is on the Kaiser Permanente formulary or find a medication’s equivalent on the formulary by calling a Kaiser Permanente pharmacist at the Clinical Pharmacy Call Center at 800-700-1479 (TTY 711), 24 hours a day, 7 days a week.
- Send your itemized bill and receipts to the following address:
MedImpact Healthcare Systems, Inc.
PO Box 509098
San Diego, CA 92150-9098 - You can also email them to Claims@Medimpact.com or fax them to 858-549-1569
- Send your itemized bill and receipts to the following address:
**Subject to Kaiser Permanente formulary.
***Depending on your specific plan provisions, maintenance medication refills must be filled at one of our Kaiser Permanente Plan medical center pharmacies or through the Kaiser Permanente mail order program, or the maintenance medication will not be covered.
How to save money on prescriptions.
- You can fill prescriptions you get from Kaiser Permanente providers and out-of-network providers at Kaiser Permanente medical centers, 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).
- If you present a prescription for a drug that is not on the Kaiser Permanente formulary, the Kaiser Permanente pharmacist will likely check with the prescribing physician to determine if a therapeutic equivalent from the Kaiser Permanente formulary can be substituted.
- Information will become part of your Kaiser Permanente medical record, for better-coordinated care.
Find out what drugs are covered.
- To find out if your prescription medications are on the plan drug formulary you can visit kp.org/formulary choose your region and select the HMO Formulary link.