If you receive a prescription order from your physician, present it along with your EmpiRx Health ID card at the participating pharmacy of your choice. Once you receive your medication you will be asked to pay a co-payment as required by your program; the remainder of the cost of your prescription will be paid by your plan sponsor.
Your employee benefits administrator determines who is eligible for benefits. Please call EmpiRx Health member services at 877-241-7123 with any eligibility related questions Including adding or terminating a dependent, address or name changes.
If you have used your EmpiRx Health card at a pharmacy before they may have your card information on file in their computer system. If that is the case, you will only need to present your prescription and your personal identification, e.g. driver's license. If you are having any problems getting your prescription filled call us directly at
If you are having any problems you can always pay for the prescription and file a reimbursement form later. It is very important to note, that depending on your plan parameters, your reimbursement may be significantly less than your actual out of pocket expense.
Should you choose to go to a non-participating pharmacy you may submit a Claim Form along with an itemized receipt. You may print the Direct Member reimbursement form from the Forms page or you can call Member Services at 877-241-7123 and request to have a form mailed to you. Reimbursement amounts will be based on your program coverage which is typically less than the amount you paid out-of-pocket.
Drug coverage and co-pays vary depending on your program and are identified under Benefits. Your pharmacist has online access to your program. If you have any questions, please contact our member services center at
A brand name drug is a prescription drug manufactured and marketed under a trademark by a specific drug manufacturer. It is the proprietary or patent protected product usually available from only one manufacturer.
A generic medication is a prescription drug that has the same active ingredients as a brand name drug. Generic drugs usually cost less than brand name drugs and are approved by the Food and Drug Administration (FDA) as safe and effective.
The Preferred Medication List, also called a formulary, identifies the cost-effective medications in each drug category. Preferred Medications are effective treatments that tend to be either unique or less expensive when compared to other drugs in their class. The list can be viewed on this website once you sign in. Your plan design may require you to pay different copayments depending on whether you are prescribed a preferred drug or not. It is important to note that the list may be modified from time to time.
Certain medications in your program may require a clinical review for prior authorization. In those instances, your pharmacist will be notified that your physician must be contacted before your program can cover your prescription. Either you or your pharmacist will need to contact your physician to ask them to call EmpiRx Health. Upon determination, we will notify you, your physician and your pharmacist of the outcome.