How do I submit a Prescription for sharing?

Can I get reimbursed for an RX I purchased?

You can submit a prescription for sharing using the Medical Expense Form. You can complete your medical expense form online here

Completing a medical expense form requires detailed information. Please provide as much as you can to ensure timely processing. Missing information may delay processing.  Everything you need will be found on the Prescription bottle. You may submit a clear picture of the information with your request.

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Per the Guidelines: If a Member must submit a bill for processing, it must be submitted electronically using the Medical Expense Form at When submitting a Medical Expense Form (MEF), members are responsible for obtaining all information needed for processing. Only MEFs that contain all needed information will be accepted for processing.


If you are completing this for your medical provider, one of the most important things to include is the ICD-10 Diagnostic code, or you can just ask your provider for the CMS1500/HCFA form or UB04 form to submit on their behalf. If you have any questions, please reach out to Member Services at 855-378-6777.


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Not sure where to find the information required?

If you have a form that looks like this red form, please just attach it to your request. It will have all the information we need.  


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