Arizona Medical Insurance

Rx Copay Plan - Low Priced Prescriptions

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A pharmacy program that works for you!

This program is designed to educate you on the use of generic and other low cost brand name drugs. This program is designed to help you find drugs within the same therapeutic class as a drug you may be currently taking. Most of all, this program is designed to save you money on your prescription drug costs.

Featuring...

• Available nationwide at over 42,000 pharmacies
• Prescription Drugs: $10 generic drugs, $20 brand name and select generic drugs, $50 brand name and
  select generic drugs, and brand named drugs at a special negotiated discount.
• Automatic Acceptance - no underwriting or health questions
• No time limits for pre-existing conditions
• No monthly or annual maximums
• Accept payment by: check, money order, MasterCard, Visa, Discover or automatic monthly bank draft

Eligibility:

You and your spouse (through age 64) and you and your spouse's unmarried dependent children under age 19.
Children age 19 and over should apply separately. Child(ren) only under 19 (no adults will be using the card), listÊthe child's name and information as the applicant and the parent or legal guardian must sign the enrollment form. If there is more than one child to be covered, list the oldest as the applicant and the othersÊunder Children. (select member + children).

Effective Date Information

If payment by credit card; the plan can be effective as early as 12:01 a.m. two days after the transmission date.    If payment by Check or Auto Check Withdrawal; the plan can become effective as early as 12:01 a.m. the day after payment is received. However, the applicant can choose a later effective date not to exceed 60 days from transmission date.

Our knowledgeable Help Desk and customer Service department ensures that all physician, member and pharmacy calls are responded to swiftly and accurately. Our prompt customer service help desk is available toll free at 866-866-2382 Monday through Friday - 9am to 4pm.

Managed By:
Rx Options, Inc.

Administered By:
Health Plan Administrators, Inc., Rockford, IL