HR Fast Facts: How Can Employees Get Reimbursed for Pharmacy Expenses?

Ultimately, the best source for finding how to get a pharmacy expense reimbursed will be through carriers. However, we have compiled some helpful tips below.

Reimbursements for pharmacy expenses within 30 days

1. Claims filed within 30 days of the prescription being filled can be directly reimbursed through the pharmacy where the prescription was filled/purchased.
   • The plan member will need to present their carrier ID card and a receipt showing the amount they originally paid.
2. The pharmacy can then run the claim for the prescription through the carrier's pharmacy claim system and provide a reimbursement for any costs that were previously paid out of pocket.
   • Reimbursements do not include copay amounts.
   • Some pharmacies will allow direct reimbursements for up to 90 days, but 30 is a good rule of thumb.

Reimbursements for pharmacy expenses after 30 days

• If the 30-day direct reimbursement period has passed or the pharmacy will not honor the receipt, the plan member would need to submit a claim form through their carrier's pharmacy vendor.
• These claim forms can be obtained on a carrier's website.
  • Reimbursement through the carrier typically takes 30 days.
  • The carrier will issue payment directly to the member.

This communication is for informational purposes only; it is not legal, tax or accounting advice; and is not an offer to sell, buy or procure insurance.

This post may contain hyperlinks to websites operated by parties other than TriNet. Such hyperlinks are provided for reference only. TriNet does not control such web sites and is not responsible for their content. Inclusion of such hyperlinks on TriNet.com does not necessarily imply any endorsement of the material on such websites or association with their operators.