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Self Service Resources
Direct Member Reimbursement
Your plan may allow for direct reimbursement. There are two situations that qualify:
1. If you bought a covered medication and did not use your pharmacy benefit card.
To submit a claim for direct member reimbursement, you may access and print the forms below.
Once you have completed the direct reimbursement form, you may scan or mail it with your prescription receipt(s) to MedImpact at Claims@MedImpact.com. You can also mail it to the address located at the bottom of the form.
Approved claims are paid within two weeks. A check will be mailed directly to you.
The information on this site is not intended to replace the diagnosis and treatment recommendations of your physician or other health care professionals. It is a resource to keep you up-to-date about your pharmacy benefit and help you manage your health by providing access to comprehensive health and wellness information.