Emergency prescription fills

If you require medication urgently outside of our business hours, your pharmacy can provide a one-time emergency override called an "emergency fill" for up to a three-day supply.

With an emergency fill, you will receive:

• No more than the prescribed amount up to a three-day supply; or
• The minimum packaging size available at the time the prescription is dispensed.

The kinds of medications that qualify for emergency fills include:

• Antibiotics & Antivirals for acute infections
• Medications for mental health conditions
• Anticoagulant / Antiplatelet medication
• Antiemetics (for imminent Nausea and Vomiting)
• Anti-Rejection/Immunosuppression medication for post-transplant patients
• Antiretrovirals (continuing current therapy, not new starts except for emergency use)
• Cardiovascular medications for acute treatment only (e.g. antiarrhythmics, anti-hypertensives)
• Epinephrine injections
• Generically available, immediate release pain medication (does not include transmucosal immediate release fentanyl)
• Gout flare (acute) medications
• Insulin (continuing current therapy, not new starts)
• Naloxone
• Non-OTC pediculicides--lice and scabies treatments
• Rescue Inhalants and delivery support devices
• Seizure/epilepsy medications
• Triptans

If you need to fill an urgent prescription during nonbusiness hours, please visit an in-network pharmacy. A one-time override called an “emergency fill” can be completed if the following conditions are met:

• You are currently participating in a Wellpoint group or individual and family health plan.
• Waiting for the medication could lead to an urgent need for emergency care, hospital admission, or potentially endanger your life, health, or that of others around you.
• The drug qualifies for emergency refills.
• You request the medication from an in-network pharmacy.
• The medication's intended use and dosage must comply with FDA-approved guidelines.
• For quantities beyond the emergency fill, follow-up refills will be subject to Wellpoint’s regular prior authorization process.

For an emergency fill, you will pay your regular copay, coinsurance, or the cost of the medication, whichever amount is lower. Any deductible you have will still need to be met.