Most drug benefits do not include coverage for non-participating pharmacies, unless the prescription is obtained in conjunction with a covered emergency. If you fill your prescription at a non-participating pharmacy, you must pay the pharmacist for the entire cost of the prescription and then submit a claim form to be reimbursed. If the claim is approved, your co-payment or co-insurance may be more than you would have paid, if you had used a participating pharmacy. Depending on the design of your benefit, you will also be responsible for any penalties, deductibles, and applicable co-payment/co-insurance. Check your Evidence of Coverage (EOC) or Certificate of Insurance (COI) for your specific copayment information.
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