Pharmacy Coverage
Prescription Drugs
For the prescription drug benefit, members need to present their prescription and their Values Health ID card at a Values Health participating pharmacy. Members are responsible for the full cost of the prescription if it is filled at a non-participating pharmacy.
If the pharmacy has a problem determining a member's eligibility, it should contact Member Services at 1-888-814-6643 (toll free). If the pharmacy has a problem with the prescription or the copay, it should call our Pharmacy Benefit Manager, Prime Therapeutics, at 1-800-821-4795 (toll free). You can find these numbers on the back of the member's Values Health ID card.
Please note that the copay for the prescription is based upon the specific drug that the health care provider prescribes. If a generic drug is prescribed, the member will pay a small copay. If a brand name drug is prescribed, the member will pay the full price, as Values Health does not cover brand name drugs.
Diabetes Supplies
Diabetes supplies such as syringes, monitoring strips, and glucometers are covered at participating pharmacies for members with diabetes.
