If approved, members will pay one copay or other applicable cost share based on their benefits for each 30-day supply of medication authorized.
The quantity of medication authorized may vary based on recent member claims, Quartz coverage term dates and travel information submitted. If medication supplies greater than the amount authorized are needed, the additional supply will need to be purchased at full cost.
This cost may be eligible for Member Reimbursement Form upon return from travel. This is only available if members maintain continuous Quartz prescription coverage throughout the trip and through the completion of the reimbursement process.