[February 22, 2008]

Earlier this year, information was provided about the transition of maintenance medications for those transferring from PacifiCare to Health Net on January 1, 2008. To help facilitate an easy transition to Health Net, arrangements were made to continue (for a limited time) the PacifiCare co-pays for maintenance medications that cost more under Health Net. The following program requirements must be met in order to qualify:

• The "maintenance medication(s)" must be included on the attached list.
• You must have filled a prescription for the maintenance medication(s) through PacifiCare in the last quarter of 2007 (October 1, 2007 - December 31, 2007)
• You must refill your prescription with Health Net between January 1, 2008 and April 30, 2008.
• The medication has a higher co-pay under Health Net than under PacifiCare.

If you refilled your maintenance medication between January 1, 2008 and February 1, 2008, you may have been over-charged by Health Net. If you believe you qualify for reimbursement, you have two methods to be reimbursed for the overpayments.

1. You may complete a claim form and submit it to Health Net with your receipt to be reimbursed for the difference now. As long as you include the paperwork provided by the pharmacy with your claim form, there is no need to have the pharmacist sign the form as indicated. If you qualify, you should receive your reimbursement within 30 days of Health Net receiving your completed claim form.
2. You may wait until after April 30, 2008, at which time Health Net will run a report of anyone who qualified for this pharmacy transition program and compare the copayments they paid. If you are identified as being overcharged, Health Net will reimburse you by check, mailed to your home address; you will receive any reimbursement 45-60 days later.

After May 1, you will pay the higher copay, as indicated in your Health Net Evidence of Coverage booklet.

• The information presented in these news archive articles may no longer be current. Please note the date when the article was first published.