Ascension_Personalized_Care_ACA_health_plans_pharmacy_benefits_plan

Pharmacy and medical drug benefits

Ascension's prescription drug plan is automatically included in your Ascension Personalized Care medical coverage. Cigna will be your pharmacy provider for 2023. APC will be switching to MaxorPlus beginning January 2024. More information to come.

Important pharmacy benefit and ID card information

Find information regarding 2024 pharmacy benefits here.
A Cigna pharmacy ID card will be sent to you for Cigna's drug plan in 2023. Your pharmacy ID card will be mailed 5-7 business days after becoming a member. 

An electronic copy of your new pharmacy ID card will be available in the
member portal and app for you to use.

Your new drug plan ID card is different from your medical card. And your pharmacy ID card must be used for coverage when filling prescriptions. You cannot use your medical ID card to fill a prescription. 

Use my.Cigna.com for 24/7 access to:

  • See your pharmacy claim history
  • Read your benefit details
  • Get recent industry and Cigna news
  • Compare drug and pharmacy prices
  • Manage your Cigna home delivery pharmacy orders
  • Ask a pharmacist a question

Home Delivery 

Having your prescriptions delivered to your home through the mail is a great way for you to save time and money. Getting 90-day refills can help you save money on your out-of-pocket prescription costs. Members may order a 90-day supply through Cigna’s mail order pharmacy called Express Scripts.

Pharmacy out-of-pocket costs

Pharmacy out-of-pocket costs, which means the cost you have to pay, will vary by each plan. Please refer to your summary of benefits and coverage for detailed information about pharmacy copays, coinsurance, and deductibles.

Get specialty prescription medications with Ascension Rx

Specialty medications usually have a high cost and are used to treat chronic and complex medical conditions. They also may be drugs that are difficult to take or have special handling, shipping and storage needs. They are often self-injected to treat conditions such as rheumatoid arthritis, multiple sclerosis, psoriasis, cystic fibrosis, cancer, or hemophilia. For specialty pharmacy needs, please have your doctor or provider fill your prescription through Ascension Rx. This does not include medical drugs, nor office administered drugs that are covered on your medical benefits.

Ascension Rx specialty pharmacy operating hours are Monday through Friday, 9:00 a.m. to 5:00 p.m. EST. For more information, please call Ascension Rx specialty pharmacy at 855-292-1427. 

If you do not have access to Ascension Rx specialty pharmacy, you may fill specialty pharmacy prescriptions through Accredo, which is a Cigna Specialty pharmacy at 866-759-1557.

Doctor administered specialty medications, medical drugs or infusions on your medical benefits

(Your doctor or physician's office must submit the prior authorization)

All physician-administered specialty medications or infusion therapies are subject to precertification notification or prior authorization (PA) approval. For a complete product list with current requirements, please see the medical benefit drug formulary list. You can also view: 

  1. No Precert, No PA required: List of products that do not require a precertification or a prior authorization. 
  2. PA required: List of products requiring PA - includes a link using Brand Name to prior authorization clinical criteria for use documents. For those without clinical criteria listed, InterQual will be used.

With questions:

  • Call 833-980-2352 to speak to a member of the Ascension Rx prior authorization team.
  • Call 866-356-3666 to confirm a patient's Ascension Personalized Care Plan eligibility.

To submit a precertification notification or prior authorization request for a physician-administered product or infusion therapy:

  1. Download the form: Medical benefit drug precertification notification and PA form.
  2. Complete and sign the form.
  3. Submit the completed and signed form:
Ascension_personalized_Care_ACA_health_plans_Pharmacy_tools

Important pharmacy benefit documents and more

Pharmacy and medical drug benefits

Contact Ascension Personalized Care: 833-600-1311

Hours of operation:
Monday through Friday, 8:00 a.m. to 6:00 p.m. EST