Frequently Asked Questions

What does it mean when a pharmacy says they do not participate?
Universal Rx offers its member cardholders a network of over 65,000 participating pharmacies. A participating pharmacy is one who has contracted with Universal Rx to provide prescription services to Universal Rx cardholders. If a pharmacy has not contracted with Universal Rx to provide such services any prescription claims attempted to be filled by this pharmacy will “reject” or, not process using the cardholders benefits. In such cases the pharmacy can call the Pharmacy Help Desk number located on the member’s drug card to become enrolled as a participating pharmacy.

How do I know if my pharmacy participates?
Cardholders can select the Retail Pharmacy Network link on the right under Plan Member Resources. A partial list of participating pharmacy chains will be provided. Also included is a link to our Pharmacy Locator where cardholders can enter their ZIP code to locate the nearest participating pharmacies.

May I obtain my medications from a non-participating pharmacy?
With an extensive pharmacy network of over 65,000 participating pharmacies, it is easier to find a pharmacy in our network than out of the network. If you choose to utilize a non-participating pharmacy, you will pay 100% of the cost of the medication out of pocket. If your benefits plan allows, you may submit a reimbursement claim form along with the original pharmacy receipt; however, this option will usually cost you more than using a participating pharmacy.

What if I lose my drug card and need a prescription filled right away?
Members are encouraged to carry their prescription drug card with them at all times. However, in situations where a drug card is not available and a prescription is needed, the pharmacist can call the Pharmacy Help Desk at 1-800-767-4226 to obtain all the necessary information to process the claim.

If I misplace my prescription drug card how can I obtain a new one?
If a new prescription drug card is needed, cardholders should notify their Benefits Manager.

Do prices vary among participating pharmacies?
Universal Rx contracts a price with each pharmacy. Prices vary from pharmacy to pharmacy, but usually only slightly.

Does my doctor need to know about my prescription drug coverage when writing my prescription?
Yes, by letting your physician know your plan co-pay structure, he can prescribe a less expensive generic or alternate drugs that fall into a lower price co-pay category instead of prescribing the higher cost brand medication. Yourprescription drug formulary provides a list of the most commonly utilized drugs and it is always advantageous to take your drug formulary with you to the Physician’s office.

What is a formulary list?
Some prescription benefit plans now utilize the three tier co-payment structure. When this co-payment structure is used, members are given a “formulary list” which provides a partial listing of the most commonly used medications and what co-payment tier the medications fall under. If a medication is not on the list, you may contact Universal Rx at 540-777-7179 to determine which tier medication falls under.

Formularies help keep drugs affordable by providing medications that are equally effective in treating an illness when compared to the other medications available, but are generally the more cost effective choices. Please consult with your physician to discuss which drugs are most appropriate for you.  

Should I ask my doctor to approve a generic substitution whenever possible?
Yes, a generic drug is a copy of the brand name medication and typically offers a substantial savings over the brand name drug. The generic drug is preferred if your physician has confirmed it is acceptable for you to take it. By using the generic drug, it saves both you and your employer money.

My doctor prescribed a brand medication. Why did I receive a generic?
This means the box marked “may substitute” was checked on the prescription. If this box is checked, it means your physician has allowed the pharmacy to substitute the generic drug when there is one available.

How do I transfer my prescription from a non-participating pharmacy to a Universal Rx participating pharmacy?
The new participating pharmacy can contact the old non-participating pharmacy and request a transfer of the prescription.

Where can I get a summary of my benefits?
Most employers either distribute a benefits booklet directly to their employees or provide information on their internal website. Contact your employer’s benefits office to request this information.

What are your customer service hours?
The Pharmacy Help Desk hours are:

Monday–Friday, 8:30am-10:00pm and Saturday, 9:00am-5:00pm (EST)

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If you have additional questions, please Contact Us using the member inquiry form.

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