What is a Pharmacy Claim?

Any medication that has been prescribed by a doctor, and is picked up at the pharmacy window, should be submitted as a pharmacy claim. This includes mail-order pharmacies. This does not include medications purchased over-the-counter.*

How to Submit Your Pharmacy Claim

To submit a pharmacy claim, you will fill out and sign a claim form (electronically or written) and send documentation verifying the expense. 

Pharmacy claim documentation requires 5 pieces of information:

  1. Name of pharmacy
  2. Your name (or name of person medication is for)
  3. Amount you paid for the medication
  4. Name of the drug and/or Rx number
  5. Date the prescription was filled

All these things are found in one place, the prescription tag that you receive when you pick up your medication. Other acceptable forms of documentation include a prescription history or an Explanation of Benefits (EOB).

Tips for Submitting Your Pharmacy Claim

  • When you fill out the claim form, use the date the prescription was filled.
  • Send a document that matches the date on your claim form.
  • Each prescription with a different filled date must be submitted via a separate claim. If you have multiple prescriptions with the same fill date, feel free to include them all under one claim!
  • Claims can be submitted to Zane Benefits online, as well as by fax or email. 

*Over-the-counter drugs, such as Advil and cold medicine, might be reimbursable through your Zane Plan. However, they should be submitted as over-the-counter claims, and require a doctor’s prescription.

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