Helping you manage pharmacy benefits Forms

Reimbursement Form

Circumstances may occur when you may be due a refund from True Rx Health Specialists for a medication that was not covered initially at the pharmacy. If this is the case, simply download the drug reimbursement claim form and follow the instructions. Mailing instructions are included at the bottom of the page.

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Prior Authorization Form

A Prior Authorization is the process in which information regarding a certain medication is gathered and clinically evaluated to determine if the prescription benefit plan will cover their portion of the medication cost. Some plans set limits on certain medications due to age, efficacy, cost, and availability.

If a prior authorization is needed, your doctor's office will need to complete this form. Instructions, including contact information, are included on the form.

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Mail Order

If your plan allows, you may have access to home delivery for medications. This is provided by WB Rx Express. To begin the mail order process, complete the online form or call 833-899-3925.

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