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 call 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 Plan does EnvisionRx Plus offer?
EnvisionRx Plus offers two plans –
EnvisionRx Plus Silver and
EnvisionRx Plus Clear Choice.
Our Silver Plan is an actuarially equivalent standard plan, which is available
in all 50 states, the District of Columbia, Guam, and Puerto Rico. Our Clear
Choice Plan is an enhanced plan offered in Connecticut, Main, Massachusetts, Michigan, New Hampshire, Oregon, Pennsylvania, Rhode Island, South Carolina, Vermont, Washington and West Virginia.
Is it really necessary to have prescription coverage?
The cost for prescription medications continues 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. The formulary may change at any time. You will receive notice when necessary.
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
There are more than 54,000 pharmacies that participate in the
EnvisionRx Plus national network. This includes pharmacies like Walgreens, Giant Eagle, HEB, Kroeger, Safeway, Albertson’s, Rite Aid, and other chains as well as a large choice of independent pharmacies. The pharmacy network may change at any time. You will receive notice when necessary.
Does your plan have Preferred Cost-Sharing Pharmacies?
EnvisionRx Plus has a Preferred Pharmacy Network,
which offers a lower cost-sharing for our members. Contact a Member Services Representative
or go to our Pharmacy Locator and
search for pharmacies in your area. Your search result will list our pharmacies
with preferred cost-sharing before listing our standard cost-sharing pharmacies.
Can I get my prescriptions through mail order?
Yes. EnvisionRx Plus offers mail order prescriptions through Orchard Pharmacy. Orchard Pharmaceutical Services is the preferred mail-order pharmacy in our network. They can be reached at 1-866-909-5170 Monday through Friday 8am to 10pm eastern standard time and Saturday 8:30am to 4:30pm eastern standard time; TTY/TDD users should call 711. Usually your mail-order will arrive in 14 days or less. If your mail-order is delayed, call the above number for your order status, and you may be able to receive a temporary supply at your local pharmacy. If you choose to receive your prescriptions through mail order, you also have the option to sign up for an automatic refill program.
What is my monthly premium?
The premium varies by state and your plan selection. Contact a Member Services Representative
for more information or use the Plan Benefit & Drug Costs tool under the menu selection of Our Plan on the website.
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. Credit card payments may be taken by phone or online at I Am A Member. For online payment locate the button that says: Make A Premium Payment. Remember, you must continue to pay Part B premium.
How do I enroll?
You can obtain an informational packet and enrollment form by contacting a Member
Services Representative at
or you can enroll online by clicking the button below. Open enrollment begins on
of each year and ends on