2026 Pharmacy Benefits

SmithRx’s Connect 360 programs are designed to help you access high-cost medications with little to no co-payment. The proactive team at SmithRx will guide you through the process of utilizing these programs, ensuring they receive the most cost-effective medication solutions.

WHAT IS A PHARMACY BENEFIT MANAGER?

Pharmacy benefits managers (or PBMs) coordinate the interaction between your employer, physician, health plan, and pharmacy. Your PBM powers your pharmacy experience by:

Making sure you’re charged the correct copay at the pharmacy
Setting up your medications to be covered according to your plan design
Managing clinical requirements related to your prescriptions Since your PBM benefits are closely related to your health coverage, you’re automatically covered when you enroll in your health plan.

WILL MY PHARMACY EXPERIENCE CHANGE?

You will receive a new Member ID card in the mail from Auxiant. Present this new card at the pharmacy to ensure you’re using your current plan and not overpaying for your prescriptions. PBMs like SmithRx cover medications based on lists of preferred drugs called formularies. The formulary with SmithRx may differ from your prior PBM. We’ll notify you if a change is required for your medication(s).

CAN I GO TO MY USUAL PHARMACY?

We have over 83,000 pharmacies in our network including retail pharmacies like CVS, Walgreens, RiteAid, Walmart, Costco and more. Mail order pharmacies like Amazon Pharmacy and Walmart Mail Order, and specialty pharmacies like Senderra and Costco.

FREQUENTLY ASKED QUESTIONS

What if a member has a general Rx question?

Members should reach out to the SmithRx member support team. Online chat at www.smithrx.com, email help@smithrx.com, or call 844-454-5201.

What if a member receives an email, call, or text from SmithRx?

Members should respond as soon as possible to the email or the phone number from the voicemail or text they received. Members can also reach out via online chat at www.smithrx.com, email help@smithrx.com, or call 844-454-5201.

What if a member gets a rejection at the pharmacy?

Members should follow these steps:

Make sure they have brought their new or most updated ID card to the pharmacy.
Make sure the pharmacy is using the correct/updated insurance information.
Ask the pharmacy to explain the rejection.
If the member or pharmacy still has questions, call SmithRx at 844-454-5201 immediately, ideally while the member is still at the pharmacy.

What if a member wants to check the price of their medication at various pharmacies?

Members can access the Find My Meds pricing tool by registering for the SmithRx member portal at www.mysmithrx.com. Within the tool, they can enter various drug details (ex: name, strength, quantity, and day supply) and find the price of the drug at pharmacies within a selected zip code or city.

What if a member wants to use mail order?

Members can utilize our mail order partner pharmacies for convenience and savings. Our standard mail order partner is Amazon, but some members might end up using Walmart Home Delivery if they are on particular drugs, and that would be communicated to them by our Connect team.

Amazon Pharmacy: Patients can register at www.amazon.com/smithrx and reach the pharmacy at 855-745-5725.

Prescribers can send prescriptions via electronic prescribing, fax or phone:

● Name/E-scribe: Amazon Pharmacy Home Delivery

● Amazon Pharmacy fax: 512-884-5981

● Amazon prescriber and pharmacy line: 855-206-3605

Walmart Home Delivery: Patients can reach out for enrollment assistance by calling 800-273-3455, by email at wmsrx@wal-mart.com, or register at https://www.walmart.com/cp/pharmacy-mail-order/1042239.

Prescribers can send prescriptions via electronic prescribing, fax or phone:

● Walmart Pharmacy fax: 800 406-8976

● Walmart prescriber and pharmacy line: 800 273-3455

● Website: https://www.walmart.com/cp/1042239

Mark Cuban’s Cost Plus (MCCP) pharmacy is another in-network mail order option. Members can check the Cost Plus website to see if generic medications are available there for a lower cost than what they are paying at retail. Additionally, the SmithRx Connect team may reach out to members about transitioning certain medications to MCCP.

Mark Cuban Cost Plus Drugs: Patients can see whether their medications are available at https://costplusdrugs.com/medications, contact the pharmacy by completing the form at costplusdrugs.com/contact/support, or contact Truepill (NPI: 1851947139) at (650) 353-5495.

Once your script has been sent by your prescriber to Mark Cuban Cost Plus Drug Company, you can register at costplusdrugs.com.

Prescribers can send prescriptions via electronic prescribing to:

● Name/E-scribe: Mark Cuban Cost Plus Drug Company (MCCPD)

What if a member is looking for more information on the cost, shipment, or delivery of their mail order or specialty medication?

Members should reach out directly to the pharmacy that processed their medication.

What if a drug has a prior authorization (PA) requirement?

Members can identify PA drugs using the formulary lookup tool on the member portal. Members should advise their doctor to fax completed PA forms to SmithRx. 866-642-5620 Prescribers should call SmithRx with any questions. 844-512-3030 If members have questions about the PA, they should reach out to the SmithRx member support team. Online chat at www.smithrx.com, email help@smithrx.com, or call 844-454-5201.

What if a member has Connect 360 related questions?

Members should reach out to the SmithRx Connect team. Online chat at www.smithrx.com, email connect@smithrx.com, or call 844-385-7612.

What if a drug has a step therapy (ST) requirement and the member wants to understand the process?

Members can identify ST drugs using the formulary lookup tool on the member portal. Members should reach out to the SmithRx member support team. Online chat at www.smithrx.com, email help@smithrx.com, or call 844-454-5201.

What if a member is currently taking a Specialty Drug/Medication?

If a member is taking a Specialty Drug such as Aimovig, Corlanor, Dupixent, Enbrel, Norditropin, Otezla, Repatha, Stelara, Sucraid, Tremfya, you can use the same method as before to fill your script on or after 1/1/2025 (be sure to do so within the first 60-days of the new year), at which point SmithRX will make outreach and work directly with you on next steps. It is VERY important that you engage with SmithRX and provide them with the information they request.

What if a member’s drug is considered specialty?

Members can identify specialty drugs using the Formulary Lookup tool on the member portal. Members should advise their doctor to send the script to Costco Specialty or Senderra Rx.

Costco Specialty Pharmacy:Patients can reach Costco Specialty Pharmacy for enrollment assistance by calling 855-213-0070. Prescribers can call 855-213-0070. Patients can also create an account on the Costco Pharmacy Member Portal at https://myportal-costco.lumicera.com/login.

Senderra Rx: Patients can reach Senderra for enrollment assistance by calling 888-777-5547. Prescribers can visit https://senderrarx.com/prescribers and fill out the appropriate forms for the appropriate department.

Once the member’s prescriber has sent the script to the specialty pharmacy, the member should call the pharmacy to provide their insurance information and to schedule delivery.