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FAQ’S

FAQ’S

Anthem

WHEN DO I NEED TO CONTACT ANTHEM FOR INFORMATION

WHEN DO I NEED TO CONTACT CONTRACTORS HEALTH TRUST (CHT) FOR INFORMATION?

DOES ANTHEM OFFER ANY HEALTH-RELATED PRODUCT AND SERVICE DISCOUNTS?

Yes. Anthem offers select health-related product and service discounts through SpecialOffers@Anthem.

Here are some of the discounts included:

This is just a snapshot of what we have available to ensure you and your family can make the most of your benefit coverage.

ARE THERE ANY TOOLS OR RESOURCES TO COMPARE COSTS OF VARIOUS PROCEDURES, DIAGNOSTIC TESTS OR OFFICE VISITS?

Yes. Anthem Care Comparison helps you understand the cost differences at local facilities for selected procedures, diagnostic tests and office visits.

Your health is too important to leave to chance. If different places charge different amounts for the same service, we think you deserve to know that. Especially if you share in those out-of-pocket costs. Having a clear understanding of cost and quality can help you make more informed decisions. And that could lead to better health!

Services included in Anthem Care Comparison are common elective, non-emergency procedures available in your member’s geographic area. You can select from a list of inpatient procedures, outpatient procedures, diagnostic tests and office visits. From time to time, new services and features will be added it becomes available.

This innovative tool allows your members to make comparisons based on the quality factors that matter most to them. Like the number of specific procedures performed, patient safety, facility complication rates, mortality rates and average length of stay.

ARE THERE ANY HEALTH AND WELLNESS TOOLS AND OTHER RESOURCES AVAILABLE ONLINE?

Yes. Anthem offers a suite of interactive online health-related tools and resources. Health assessments, Health news, as well as a searchable library of more than 25,000 articles, reports and news stories on a wide
range of health and wellness topics, Preventive health guidelines, Patient safety information, and a Medical reference encyclopedia of health topics from A to Z.

IS THERE A MOBILE DEVICE PROVIDER FINDER?

Yes, you can search for a health care provider from mobile device.  Download the Sydney Member Mobile app from the Anthem website www.anthem.com for provider and other information.

HOW DO I FIND A DOCTOR?

Locate in-network providers through Anthem’s online provider finder by going to www.anthem.com and selecting the Find a Provider link or calling 1-800-810-2583. The directory allows you to search for both doctors and health care facilities (including urgent care facilities).  A search can be made more specific by choosing a specialty, entering the name of a doctor or a facility, selecting a gender, languages spoken or if a doctor is accepting new patients and can serve as a primary care physician. Once the required information is entered, a list of doctors or facilities that matches the search criteria will display. You’ll save money if you see a participating Anthem in-network provider or Blue Card participating provider.

WHAT DO I DO IF I NEED TO SEEK CARE OUTSIDE THE STATE OF COLORADO?

You have access to the national Blue Card (BCBS) Network of providers. Just have the provider send your claim to their local host BCBS plan. You’ll save money if you see a participating Anthem in-network provider or Blue Card participating provider. If you need to find a participating Blue Card provider call 1-800-810-2583 and ask for providers in the Blue Card network.

WHY DOES MY CARD HAVE AN ANTHEM LOGO ON IT?

Contractors Health Trust contracts with Anthem in order to provide you with the strongest provider network in the state of Colorado.

COBRA

WHERE CAN I FIND MORE INFORMATION ON COBRA?

More information can be found by visiting COBRA FAQ’s.

Your Rights and Protections Against Surprise Medical Bills

When you receive emergency care (other than ground ambulance services) or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible (referred to as “cost-sharing amounts”). You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in the Plan’s network.

“Out-of-network” means providers and facilities that aren’t contracted with your Plan’s network to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and does not count toward your deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

You’re protected from balance billing for:

Emergency services
If you have an emergency medical condition and get emergency services (other than ground ambulance services) from an out-of-network provider, facility, or air ambulance, the most they can bill you is the Plan’s in-network cost-sharing amounts. You can’t be balance billed for these emergency services. This includes services you may receive after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you receive services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is
the Plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you receive other types of services at an in-network facility, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You are never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in the Plan’s network.

When balance billing isn’t allowed, you also have these protections:

If you have questions about this Notice or balance billing, contact the Fund Office at: 303-935-2475 or toll free 833-935-2475

If you think you’ve been wrongly billed, contact the Department of Health and Human Services (HHS) via its toll-free number at 1-800-985-3059.

Visit https://www.cms.gov/nosurprises/consumers for more information about your rights under federal law.

Dental

* These items apply to those employees who are covered for Dental and Vision benefits. Dental and Vision benefits are offered as optional coverage’s on an employer by employer basis.

AM I ELIGIBLE FOR DENTAL BENEFITS?

Dental benefits are optional on an employer-by-employer basis. If your employer elected to provide dental benefits, then you are eligible for them. Please check with your employer to verify if you have this coverage.

HOW DO I GET STARTED?

Enrolling in Delta Dental’s PPO plus Premier or the Alpha Dental’s Discount plan is easy. See your employer for enrollment information.

HOW DOES THE CALENDAR YEAR MAXIMUM WORK?

A calendar year refers to a period of January 1 through December 31.  Under the Delta Dental Plan, your  coverage maximum starts fresh each January 1. These totals are not pro-rated: The full coverage maximum applies, no matter your start date. There are no maximum coverage limits under the Alpha Dental Plan.

WHAT IF SOMEONE IN MY FAMILY HAS ANOTHER DENTAL INSURANCE PLAN?

When someone has additional dental coverage, one plan is usually primary. This means that your dentist sends the claim for service to the primary insurance plan and may also submit it to a secondary plan. Delta Dental will coordinate benefits if a subscriber has coverage under more than one dental plan.  Alpha Dental is a discount plan where services are paid for at the time of service and there is no coordination of benefits.

WHAT IF I RESIDE OR HAVE AN EMERGENCY OUTSIDE THE UNITED STATES?

You will need to pay the bill at the time of service. Send your receipt and claim to Delta Dental at P.O. Box 173803, Denver, CO 80217-3803 or email to international_claims@ddpco.com.  Alpha Dental has no Out of Network benefits.

WHAT IS AVAILABLE ON YOUR WEBSITE?

Both Delta Dental’s and Alpha Dental’s websites allow you to locate participating dentists, view benefits, view your claims, print explanation of benefits, find dental health information, take a dental risk assessment and much more.

DO I NEED AN ID CARD?

An ID card is not required to access services under Delta Dental Plan. Once you are enrolled with Delta Dental, you can print a customized ID card by registering for Subscriber Connection on the Delta Dental website www.deltadentalco.com  You will receive a separate ID card for your coverage through Alpha Dental.

WHAT IF I AM IN THE MIDDLE OF ORTHODONTIC TREATMENT?

Delta Dental will “takeover” the orthodontic treatment. We will calculate the treatment based on the dentist’s original treatment plan as if the treatment was started under the Delta Dental PPO plus Premier Plan. We will deduct any down payment or payments that we would have paid if we started the case and pro-rate the remaining payments.  For Alpha Dental contact Beta Health at betaplans.com.

WHAT HAPPENS IF I VISIT A NON-PARTICIPATING DENTIST?

If dental services are received from a dentist who does not participate with Delta Dental, you will be responsible for paying the difference between the Delta Dental Maximum Plan Allowance and what the dentist actually charges. Many non-participating dentists will ask you to pay the full fee up front. In addition, reimbursement for covered services will be paid directly to you, and you will be responsible for paying your dentist. Alpha Dental has no Out of Network benefits.

 HOW DO I FIND A  DENTIST?

Delta Dental has the largest dental network in the country, with over 130,000 dentists nationwide. Finding a participating dentist in your local area is easy. Simply visit www.deltadentalco.com, or call 1.800.610.0201.  Alpha Dental has a network of over 900 providers in Colorado.  To find a participating dentist go to betaplans.com

WHERE DO I FILE MY DENTAL CLAIMS?

If you have the optional Delta Dental benefit, all dental claims are processed by Delta Dental Plan of Colorado; P.O. Box 173803, Denver, CO 80217-3803. Telephone (303) 741-9305 or 1-800-610-0201. The Group number for Hour Bank (plan B) Participant’s is W0717-0001 and for Monthly Contribution (Plan C) Participant’s is W0717-0002.  Alpha Dental is a discount plan and all services are paid for at the time of service, there will not be any outstanding claims.

MAY I VISIT ANY DENTIST?

If you have Delta Dental coverage, yes. You have the freedom to see any dentist. A participating PPO dentist will maximize your savings. A participating Premier dentist accepts a discount off their submitted charges and provides balance billing protection to the member. You may also see a non-participating dentist. You will be responsible for the difference between the out- of-network Maximum Plan Allowance and the full fee charged by the dentist. There is no coverage for out of network dentists under the Alpha Dental plan.

WHY CHOOSE THE DELTA DENTAL PPO PLUS PREMIER PLAN?

Delta Dental has negotiated substantial discounts from participating dental providers. This means that your dollars go much further. If you choose to have no dental insurance, charges are at the dentist’s fee for service which are not discounted. Dental insurance also helps you budget for those larger unexpected expenses. Delta Dental participating dentists will file your claim and, only charge you for any deductible or coinsurance (your portion) and will bill Delta Dental for the covered portion.

Life and Accidental Death and Dismemberment (AD&D)

WHO DO I CONTACT FOR ADDITIONAL DETAILS ON THE LIFE AND AD&D BENEFIT THROUGH CHT OR IF I NEED TO FILE A CLAIM?

Contact the CHT administrative offices at 303-935-2475 or 1-833-935-2475.

WHAT ARE THE EXCLUSIONS THAT ARE APPLICABLE TO THE AD&D BENEFIT?

Please refer to the Summary Plan Description for a list of Exclusions.

HOW MUCH AD&D COVERAGE DO I HAVE AS AN EMPLOYEE (NO COVERAGE FOR SPOUSE OR DEPENDENTS)?

You are covered under the policy as an employee, however your spouse and dependents are not covered by the AD&D portion of the policy. Please refer to the Life Insurance and Accidental Death and Dismemberment section of your Summary Plan Description.

WHO IS THE BENEFICIARY OF THE LIFE INSURANCE BENEFIT UPON DEATH?

The Employee designates the Beneficiary of the Life Insurance benefit. The Beneficiary will be the person(s) named in writing to receive any amount of the insurance payable due to a death. Please refer to your Summary Plan Description for more information related to Beneficiary for Life Insurance.

IS THERE ANY ADDITIONAL OPTIONAL LIFE INSURANCE COVERAGE AVAILABLE IF I DECIDE TO PAY ADDITIONAL FOR IT?

Not at this time. Your employer may have optional Life coverage available through separate policy (not through CHT).

IS EVIDENCE OF INSURABILITY REQUIRED FOR LIFE INSURANCE?

No. You are accepted on the day your coverage becomes effective.

AT WHAT AGE CAN I COVER MY DEPENDENT CHILDREN FOR THE LIFE INSURANCE BENEFIT?

Children are covered from 14 days of age up to age 26.

HOW MUCH LIFE INSURANCE COVERAGE DO I HAVE (MYSELF AND DEPENDENTS)?

The amount of coverage is also specific to Employee, Spouse and Child. Please refer to the Life Insurance and Accidental Death and Dismemberment section of your Summary Plan Description.

WHEN IS MY LIFE INSURANCE AND AD&D COVERAGE EFFECTIVE?

Your coverage is in effect on the same day as your medical coverage.

WHO IN MY FAMILY IS COVERED FOR LIFE AND AD&D INSURANCE COVERAGE?

You are covered for Life Insurance as an employee and dependents are also covered under the policy. Only employees are provided coverage for AD&D benefits (no coverage for spouse or dependents).

IS GROUP LIFE INSURANCE OR ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) OFFERED THROUGH CONTRACTORS HEALTH TRUST(CHT)?

Yes. Group Life insurance and AD&D coverage is automatically included as part of your CHT medical coverage.

Medical

IF MY ATTENDING PHYSICIAN IS A PARTICIPATING IN-NETWORK (PPO) PHYSICIAN, ARE ALL OTHER RELATED CHARGES FILED WITH THE PLAN COVERED UNDER THE PPO BENEFIT SCHEDULE, SUCH AS PATHOLOGY CHARGES, RADIOLOGY CHARGES, ANESTHESIA CHARGES, ETC.?

No. It is your responsibility to make sure each provider of service is a PPO provider. Each provider of services is considered separately. Example: If you have surgery scheduled with a PPO Physician, his/her charges are covered under the participating Physician contract. However, services for an assistant surgeon, Physician’s assistant, pathology, radiology, etc., are considered depending on whether or not each provider is a participating PPO provider.

CAN I COVER MY DEPENDENTS WHEN THEY CEASE TO BE ELIGIBLE FOR BENEFITS AS DEFINED BY THE PLAN?

Yes, temporarily. The Administrative Office must be notified within 60 days from the date the Dependent ceased to meet the definition of a Dependent. The Dependent may continue in the Plan for a limited time under COBRA continuation by making monthly self-payments of the total required premium.

ARE MY DEPENDENT CHILDREN COVERED AFTER AGE 26?

In qualifying cases after age 26, dependent children who are incapable of self-sustaining employment by reason of mental retardation or physical handicap and such incapacity commenced prior to the date the Dependent child’s coverage would have otherwise terminated under this Plan. Application for this coverage must be filed with the Administrative Office within 31 days after coverage would have otherwise terminated.

WHAT DO I DO IF I HAVE COVERAGE UNDER THIS PLAN AND ANOTHER PLAN (SUCH AS MEDICARE) FOR MYSELF AND/OR MY DEPENDENTS?

You must submit the claims to both this Plan and the other plan; we recommend that you file your claims with both plans at the same time. When your primary Plan has processed your claim and has provided you with their “Explanation of Benefits” (EOB), send a copy of their EOB to the Administrative Office where benefits payable from this Plan will be determined.

You must meet the timely claim filing requirements of this Plan. The Administrative Office must receive billings for medical services no later than one (1) year from the date services were rendered. If your other plan fails to provide you with an EOB by the timely claim filing limitation of this Plan and we have not received notification from you of these charges, benefits will not be payable by this Plan.

WHAT HAPPENS WHEN MY SPOUSE IS ALSO EMPLOYED?

You must provide the Administrative Office with the complete name and address of your spouse’s employer. In the event your spouse has other insurance coverage through his/her employer, the following will apply: Your spouse’s carrier is always the primary payer of your spouse’s claims.

If your spouse covers Dependent children, the Plan will determine who is the primary payer based on which parent’s birthdate falls earlier in the calendar year.

DO I HAVE TO COMPLETE A CLAIM FORM WITH EACH CLAIM FILED WITH ANTHEM?

You will not need to complete a claim form with each  In-Network claim filed.  For Out-Of-Network claims a claim form must be submitted.

WHAT IF I NEED MEDICAL CARE OUTSIDE OF THE STATE?

You are covered for medical services incurred anywhere in the world, subject to Plan benefits and exclusions and limitations.

DO I HAVE TO PRECERTIFY ALL MEDICAL CARE?

No. Only if you are going to be confined in a Hospital or facility as an inpatient or receive an outpatient MRI, CT scan, PET scan or outpatient surgery. Emergency admissions must be reported to Anthem 1-800-832-7850, within two working days after the admission. Failure to report such services will subject you to a $200 penalty. Note: all mental health and substance abuse treatment must be provided through and/or referred by the EAP.

Your doctor or the Hospital may contact Anthem, but it is ultimately YOUR RESPONSIBILITY to obtain timely precertification/authorization.  You may contact Anthem by calling 1-800-832-7850.

HOW MUCH CAN I BE EXPECTED TO PAY OUT-OF-POCKET EACH YEAR?

Out-of-pocket maximums “cross accumulate” between the in-network and out-of-network Plans. If Preferred Providers are utilized, your out-of-pocket expense can be reduced. Please note, any charges that are not covered by the Plan are your responsibility in addition to the out-of-pocket expenses.

Please refer to the  Summary Plan Description to determine your specific out-of-pocket maximum.

WHAT IS A COPAYMENT?

A Copayment is a fixed dollar amount you are responsible for paying when you incur an Eligible Medical Plan expense for certain services. For information about copayments that apply to specific services, refer to your Schedule of Medical Benefits in your Summary Plan Description.

If you are enrolled in a High-Deductible Plans (Trust 3000 or Trust 5000) once your deductible has been met you are not required to make an office copayment.

Please refer to the Plan Summary Description for specific deductible information and for office visit copayment information.

WHAT CHARGES APPLY TO MY OUT-OF-NETWORK DEDUCTIBLE?

All out-of-network charges are subject to the calendar year deductible.

Out-of-Network routine preventative care services are NOT covered.

WHAT CHARGES APPLY TO MY IN-NETWORK DEDUCTIBLE?

Most Medical Plan benefits are subject to the calendar year deductibles. Such charges include but are not limited to covered Hospital charges, therapy, medical supplies and prosthetic devices when prescribed at the direction of a Preferred Provider Physician (PPO) and most Non-Preferred Provider (Non-PPO) charges. Ancillary charges such as x-ray and laboratory must be billed by the same Physician providing the office visit services. Other services performed in the Physician’s office at the time of the office visit, such as minor surgical procedures, will be subject to the deductible. Ancillary services performed outside the Physician’s office or by any other provider will be subject to the deductible.

The deductible does not apply to routine preventative care, such as physical examinations, routine mammograms, prostate screening, routine nursery care of a newborn child, routine hearing care, and Physician office visit charges, including ancillary charges. For a complete description of covered preventative care go to: http://www.healthcare.gov/law/about/provisions/services/lists.html.

WHAT IS A DEDUCTIBLE?

Your deductible is the fixed amount of eligible Medical Plan expenses during a calendar benefit period you are responsible for paying before the Plan begins to pay benefits.  Plans have both individual and family deductibles established.  Deductibles may vary between In-Network and Out-of-Network providers.  If you have a question on your deductible amount, contact customer service at 303-935-2475 or 1-833-935-2475.

ARE PRESCRIPTION DRUGS COVERED?

Yes. Please refer to the Summary Plan Description to determine specific copayments or deductible amounts that will be applicable to your prescription drugs.

HOW ARE NEW DEPENDENTS COVERED?

You must complete an enrollment card, adding your new Dependent (spouse, natural child, stepchild, legally adopted child or child for whom permanent custody is court ordered) under your coverage within 31 days of the date acquired.  Please refer to the Summary Plan Description for Dependent coverage enrollment requirements, effective date of coverage and eligibility requirements.  An enrollment card must be received by the Administrative Office within 31 days of marriage, birth, adoption or court order, otherwise your Dependent’s coverage will be delayed or may be subject to preexisting condition limitations.

Proof of dependency should be included with your enrollment card such as marriage records, birth certificates and court approved permanent custody documents or other applicable documents.

Please note: If the enrollment request is not received within 31 days, your dependents cannot be enrolled until Open Enrollment which occurs January 1 or each year.

Prescription Drugs

Contractors Health Trust has made some changes with the pharmacy benefit plan and is excited to partner with MedImpact Healthcare Systems, Inc. to administer your pharmacy needs effective January 1, 2024. Please see below with information about MedImpact and if you have any questions about our previous pharmacy benefit plan with Express Scripts please call them at 877-551-8811 or call Contractors Health Trust at 303-935-2475.

Who is MedImpact?

Contractors Health Trust contracts with MedImpact to manage your prescription drug benefit. MedImpact was founded more than three decades ago by a pharmacist and independent drug store owner who saw firsthand how families struggled with the high cost of prescriptions, and how it impacted their lives, financial security, and health. MedImpact was started to make prescription benefits understandable and accessible. While we have grown to be one of the leading PBMs in America, we remain as committed to these principles today as we did when it all began.

How do I register with MedImpact Direct Mail®?

Birdi™ pharmacy makes it easy to manage the medicine you take to stay healthy. First, check with your employer or health plan to see if you are eligible. Then, to start mail-order service, you will need a 90-day-supply prescription(s) from your doctor.

How Do I Get Started?

Sign in to www.medimpact.com, or use the mobile app “MedImpact.” The app is available on Android and iOS. Once you register, you may review details about your medicines, request new prescriptions or refills, and manage your shipping/payment details.

You can request updates about your orders to be sent by email, text, or automated phone call. When signing up for email notifications, please add the Birdi email to your list of safe recipients. You will receive a confirmation email from Birdi after registration, if you do not, check your junk email. If you receive no confirmation email, please contact Birdi at 1-855-873-8739 (TTY dial 711):
Monday – Friday 8 am – 8 pm Eastern Time
Saturday 9 am – 5 pm Eastern Time

How Do I Set Up New Prescriptions?

Option #1: Your Doctor Sends Us Your Prescription
Your doctor directly submits your prescription electronically or by fax to 1-888-783-1773. We can only accept faxes from your doctor. When we receive a new prescription from your doctor, we will process the order and ship it to you at the primary address on your patient profile. Controlled substances will not be shipped without your approval.

Option #2: Sign in to Website
Sign in to our website to request a new prescription or transfer one from a retail pharmacy. Choose “Request a Prescription” at the top of “My Medications > Prescription List” page and follow instructions. Once your new prescription is processed, you can track orders at www.medimpact.com or on the mobile app.

Option #3: Mail Us Your Prescription
Sign in to www.medimpact.com and visit Documents > Medication Order Form. Send the form with your prescription(s) to:
Birdi
PO Box 8004 Novi, Michigan 48376-8004

How do I find out the status of my order?

Sign in to www.medimpact.com or our mobile app and select “My Medications” to check your order status.

How do I transfer my existing prescription from another mail-order
pharmacy?

Depending on your mail-order pharmacy, we may have received an electronic transfer of your prescription refills. If so, you will need to set up your profile first by registering at www.medimpact.com. To complete your profile, you will need to add any health conditions or allergies you may have.

New prescriptions for controlled substances, or prescriptions that have expired, were never filled, or have no refills remaining will not automatically transfer from your previous mail-order pharmacy. Birdi can help you get these medications, just call us at 1-855-873-8739 (TTY dial 711).

You can request most new prescriptions after signing into the website. Choose “Request a Prescription” at the top of “My Medications > Prescription List” page and follow instructions. You will need to contact your doctor for a new prescription for controlled substances.

How do I transfer my existing prescription from another retail pharmacy?

You can request a prescription transfer for most medications after signing in to www.medimpact.com. Choose “Prescription Transfer” at the top of “My Medications > Prescription List” page and follow instructions. You will need to contact your doctor for a new prescription for controlled substances.

How do I order refills?

Sign in to www.medimpact.com and click the “Register Now” button to create an account. Type in the member identification number from your member ID card, first name, last name, and date of birth. Once signed in, select the medicine(s) you need to refill, your payment method, and where you want the medicine(s) shipped.

Do you have an Auto Refill service?

Many drug benefit programs for commercial drug plans offer an Auto Refill service. Prescriptions enrolled in Auto Refill will process for shipment before the end of supply of prior prescription fill.

To enroll eligible prescriptions in Auto Refill, sign into your account at www.medimpact.com. “My Medications -> Prescription List” page and use the Auto Refill toggle.

Auto Refill is offered to Medicare and commercial members. Auto Refill is not offered to Medicaid members at this time.

How long does prescription processing and shipping take?

Orders are processed and shipped within 5 business days from receipt of prescription.

What happens if my doctor sends a prescription directly to Birdi?

When we receive a new prescription directly from your doctor, we will process the order and ship it to you if you have a complete patient profile in our pharmacy system. Controlled substances will not be shipped without your approval.

How are my medicines shipped?

Birdi will use the best method available to ship your order(s) and ensure you get your medicine(s) in a timely manner. You may choose expedited shipping for an added fee.

Can I cancel an order?

No. Once an order is placed, pharmacy dispensing begins and cannot be stopped.

What if my medicines are damaged during shipping?

Please check your prescription order for damage and accuracy as soon as it arrives. Contact Birdi with questions or concerns about the order within 14 days from the date your order was delivered. We can be reached at 1-855-873-8739 (TTY dial 711):
Monday – Friday 8 am – 8 pm Eastern Time
Saturday 9 am – 5 pm Eastern Time

What if I want to return a medicine?

Birdi does not accept the return of prescriptions once shipped. Call us with questions or concerns about your medication at 1-855-873-8739 (TTY dial 711).

How do I request a refund for my medicine?

Please check your prescription order for accuracy as soon as it arrives. Contact Birdi with questions or concerns about the order within 14 days from the date order was delivered. Birdi can be reached at 1-855-873-8739 (TTY dial 711).

How do I pay for my medicine?

All online orders require payment by credit card. For your convenience, Birdi will securely keep your credit card on file to avoid delay when you are placing an order. You can add your credit card information to your profile when you register online. Birdi also accepts checks and money orders by mail to:

PO Box 516582
Los Angeles, CA 90051

Please include your name and member ID number or the invoice sent with your medicine when mailing in a payment. Please do not send cash.

Will I receive more than one delivery?

If you order more than one prescription, it is possible you may receive more than one shipment of medicine. The packages may arrive on different days. To check your order status, sign in to www.medimpact.com or the mobile app and select “My Medications.”

How long will it take for my medicine to arrive?

Orders are processed and shipped within 5 days from receipt of prescription. We offer many refill options to ensure you receive your medicine(s) as quickly as possible. You can track the status of your order online or in the mobile app. Need it sooner? Select expedited shipping for an added fee.

Will you substitute a generic medicine?

When available and permitted by law, a generic medicine will be substituted unless you or your doctor tells us otherwise. We only substitute FDA-approved generic medicines that are equivalent to the brand-name drug under state and federal law.

Your doctor can specify brand-name medicine, if needed. You also may choose “brand-name only” medicine by speaking with the pharmacy. Please be aware that brand-name drugs may not be covered by your plan when a generic is available. Using a brand-name drug could result in a higher copay.

What if I have a question about my medicine order?

You can find answers to many questions at www.medimpact.com.

What is your email address?

You may email us at PatientCare@Birdirx.com and you will receive a response within 2 business days. For your privacy, please do not include any personal health information in your email.

What if my medicine requires a Prior Authorization?

Birdi works directly with your Pharmacy Benefit Manager (PBM) MedImpact, helping to start the prior authorization process with your doctor. The PBM will send the proper form to your doctor and make the decision on the prior authorization. Birdi will notify you that coverage of your medicine requires a prior authorization and that your PBM has begun the process. If you have questions about the prior authorization process, please call MedImpact at 1-800-788-2949 (TTY dial 711).

Click here to download the MedImpact Prior Authorization Guidelines.

What if I need after hours care?

If you are experiencing a medical emergency, call 911.

If you have a clinical need, Birdi pharmacists are available 24/7/365 at 1-855-873-8739 (TTY dial 711). After normal business hours, call toll-free to 1-855-873-8739 (TTY dial 711), press 4 and you will be routed to the answering service. Please leave a message. A pharmacist will return urgent calls within 1 hour. Non-urgent messages are handled the next business day.

How do I dispose of medicines and supplies?

Expired, broken, or unwanted medicines, including transdermal patches, must be disposed of with care. Medical supplies like needles, syringes, and diabetic testing supplies must also be disposed of properly. Visit a US agency site to learn how:

If you have questions for a pharmacist about disposal of your medicines or supplies, call Birdi toll-free at 1-855-873-8739 (TTY dial 711). Our customer service hours are:
Monday-Friday 8 am – 8 pm Eastern Time
Saturdays 9 am – 5 pm Eastern Time

Or email us at PatientCare@Birdirx.com. For security and privacy, please do not include personal health information. Email messages are replied to within two business days.

Vision

Vision benefits are offered as optional coverage on an employer by employer basis. Check with your Employer to verify coverage.

AM I ELIGIBLE FOR VISION BENEFITS?

Vision benefits are optional on an employer-by-employer basis. If your employer elected to provide vision benefits, then you are eligible for them. Please check with your employer to verify if you have this coverage.

HOW DO I OBTAIN VISION BENEFITS?

USING YOUR BENEFIT IS EASY!
Contact VSP at 1-800-877-7195 or create an account on vsp.com to view your in-network coverage, find the VSP network doctor who’s right for you, and discover savings with exclusive member extras. At your appointment, just tell them you have VSP.

A Network Provider will submit your claim to VSP and VSP will pay the provider directly.

If you receive services from a non-network vision provider, you must pay the provider and file a claim for reimbursement from VSP.

WHAT IS MY COST FOR VISION BENEFITS?

Your share of the cost will depend on the services you receive and whether you obtain them from a VSP Network Provider or a non-network provider.

VSP Network Provider

Services from a Network Provider are subject to a $25.00 copay. The vision examination is paid in full thereafter. Eyeglass lenses are paid in full less a $25.00 copay. An eyeglass frame allowance up to a $150 wholesale value is covered. For frames with a higher wholesale cost, you will receive a 20% off any overage. An allowance of $150 is provided for contact lenses in lieu of eyeglasses. You will be responsible to pay the provider for the deductible, any extras and any amount over Plan allowances. The Network Provider will submit a claim to and be paid by VSP for the covered services.

Non-network vision provider

Get the most out of your benefits and greater savings with a VSP network doctor. Call Member Services for out-of-network plan details.

Exam up to $45
Frame up to $70
Single Vision Lenses up to $30
Lined Bifocal Lenses up to $50
Lined Trifocal Lenses up to $65
Progressive Lenses up to $50
Contacts up to $105

You will be responsible for paying the non-network provider for all services. You will need to submit an itemized statement of the amounts you paid to VSP. You will be reimbursed up to a maximum per service.

HOW FREQUENTLY CAN I OBTAIN VISION BENEFITS?

You may obtain vision benefits as frequently as follows:

Vision Examination – Once every twelve months

Eyeglasses (Lenses and Frame) – Once every twelve months

Contact Lenses (in lieu of eyeglasses) – Once every twelve months

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