Prescription Plans That Work For You
It’s important to consider the number of prescriptions you and your family have when you are looking for a new health plan. We are committed to providing you with the best prescription coverage options available. We offer a tiered prescription plan to help accommodate the needs of our members with costs as well as selection of certain medications.
Pharmacy Benefit Manager Name Change
Cox HealthPlans uses Elixir (formerly known as EnvisionRX) to manage your pharmacy benefits. This name change was effective on 9/1/2020.
We partner with Elixir to administer prescription benefits for our members. Elixir provides many online tools to help you including:
- Locating a participating pharmacy
- Prescription drug pricing
- Helpful drug information
- Mail order administration and ordering
You can view your member benefits by logging in to Elixir’s secure site at www.elixirsolutions.com/. You will need to enter your Member ID number on your identification card and Date of Birth to log in.
Elixir Pharmacy Technicians are also available 24 hours a day/7 days a week to assist you with your pharmacy needs. You can call toll free at (844) 838-1522.
Making the Right Prescription Choices
Prescription Formularies give details of the covered medication tier levels and quantity limits. Download the formulary for the type of health plan you are covered under below.
Group and Individual Plans-Standard Formulary
Search 2021 Formulary
2021 Standard Formulary Updates
Short Term Medical Plans
2021 Short Term PLUS Formulary
Short Term Plus Formulary Updates
Cox Employee Health Plan – Plans offered to Employees of CoxHealth.
for 2021 Cox Employee Health Plan:
2021 Cox Employee Formulary Updates:
Cox HealthPlans MEC Preventative List:
Preferred Drug List
Download our Preferred Drug List for a guide on identifying preferred brand-name medicines within select therapeutic categories.
Individual, Employer Based
Cox Employee Health Plans
Short Term Plus Health Plans:
Maintenance Medications List
Download our prescription maintenance medication list to learn which medications are available at a 90-day supply through Elixir participating retail pharmacies or through your mail service program.
Opioid Care and Safety
The following links provide helpful information from the CDC regarding prescription of opioids along with educational resources and materials for patients.
Generic vs. Name Brand
With prescriptions, you have the choice between generic and name brand drugs. Some plans offer better coverage for generic drugs, whereas others offer coinsurance, copayments or coverage that only applies after your deductible is met. You’ll want to evaluate at what level your prescriptions are covered, and how expensive they are, to determine if you need better coverage for prescriptions.
Generic medications work like the equivalent brand name drug in dosage, strength, performance and use. All generic medications are reviewed and approved by the Food and Drug Administration to perform in the same manner. Please discuss with your Physician what Generic alternatives may be available to start saving money on your out of pocket prescription costs.
Ways to Save Money on Your Prescriptions
Mail Order Savings
If you are taking maintenance medication such as blood pressure medicine, you may want to consider using our mail order service for additional savings. You get:
- 90-day supply
- 2.5 times your copayment instead of 3
- Convenience of your medication being delivered to your home
There are numerous generic and over-the-counter (OTC) medications available for you to buy that are approved to help treat common healthcare conditions.Download PDF
Over-the-Counter (OTC) Medication Benefits
Using an over-the-counter medicine will not only save you money, but you also have more options to find the best medicine for you.Download PDF
Effective January 1, 2016, OneTouch is Now a Preferred Diabetes Testing Product on Elixir.Download PDF
Elixir Mobile App
Manage your prescription benefits using the Elixir free app on your mobile device.Download PDF
Prescription Request Form
Form that can be mailed to Elixir Pharmacy or faxed directly from physician office.Download PDF
Prescription Claim Form
This form is used if a member needs to submit a prescription claim.Download PDF
Prescription Appeal Form
This form is used for prescription appeals.Download PDF
Quantity Limit Exception Request
This form is used by a physician to request authorization for a quantity above the allowed limit on certain medications.Download PDF
Prescription Mail Order Form
This is the form used to request mail order service for prescription medications.Download PDF
Formulary Prescription Exception Form
Certain requests for coverage require review with the prescribing physician.Download PDF
Designation of Personal Representative
This form is used to designate those people allowed to receive information from Envision about your medical information and prescription claims.Download PDF
Prescription Prior Authorization
This form is used by a physician to request authorization of a particular prescription medication.Download PDF
Prescription Non Formulary Exception RequestDownload PDF
Direct Member Reimbursement
Use this form to request reimbursement for claims that your pharmacy didn't process under your insurance.Download PDF
Prescription Claim for Compound Medications
This form is used if a member needs to submit a prescription claim for compounded medications.Download PDF