Frequently Asked Questions
Below you will find a list of frequently asked questions, if you do not find the answers you are looking for please feel free to contact our knowledgeable Member Services Department at 1-866-250-2005; TTY/TDD users should call 711, 24 hours a day, 7 days a week.
What Plans does EnvisionRx Plus offer?
EnvisionRx Plus offers two plans, EnvisionRx Plus Silver (our Actuarially Equivalent standard plan) and EnvisionRx Plus Gold (our Enhanced Alternative plan). Both plans are available in all 50 states and the District of Columbia.
Is it really necessary to have prescription coverage?
The costs for prescription medications continue to grow each year. Enrolling in a Medicare approved prescription drug plan helps you to reduce your out-of-pocket costs for prescription drugs. EnvisionRx Plus uses a prescription drug formulary to lower your costs and ensure access to quality, safe, cost effective medications.
What is a formulary?
A formulary is a list of covered drugs selected by EnvisionRx Plus in consultation with a team of health care providers, which represents both brand and generic drugs in Medicare Part D Eligible Therapy Drug Classes. EnvisionRx Plus will cover the drugs listed in our formulary as long as the drug is medically necessary and you meet the CMS criteria if required. Please note that you should fill your prescription(s) at an EnvisionRx Plus network pharmacy. For more information on how to fill your prescriptions, please review your Evidence of Coverage or contact our Member Services Help Desk at 1-866-250-2005.
What if a medication I’m already taking is not included on the Plan Formulary or Drug List?
To ease your transition into an EnvisionRx Plus plan, allowances will be made during the first 90 days of coverage to allow time for you to continue on your current medication, while you and your physician discuss your treatment options.
Which pharmacies can I use to get covered prescriptions filled?
There are more than 65,000 pharmacies that participate in the EnvisionRx Plus national network. This includes pharmacies like Walgreens, Giant, HyVee, HEB, Publix, Sam’s Club, Walmart, Costco, and other chains as well as a large choice of independent pharmacies.
Can I get mail order prescriptions from Orchard Pharmacy?
Yes. If you take daily medications, covered prescription drugs are delivered to your home by Orchard Pharmacy. Please note for the Silver Plan, Orchard can only fill a 30-day supply per the benefit design.
What is my monthly premium for the Silver Plan or the Gold Plan?
The premium varies from state-to-state. Contact a Member Services Representative for more information or use the Compare Plans Cost Tool.
How do I pay plan premiums?
You can have your monthly plan premium deducted from your Social Security/ Railroad Retirement Board benefit check (just like your Part B premium) or you can pay your premium to EnvisionRx Plus directly. Premium payments may be made by credit card, check, or electronic funds transfer.
How do I enroll?
You can obtain an informational packet and enrollment form by contacting a Member Services Representative at 1-866-250-2005 or you can enroll online by clicking the button below. Open enrollment begins on October 15 of each year and ends on December 7