Washington State Rx Services

Your prescription drug benefit is managed by Washington State Rx Services (not Aetna).  Washington State Rx Services is a program administered by the Washington State Health Care Authority.

With Washington State Rx Services, you can:

• Pay a flat-rate copay for each prescription.
• Fill prescriptions at retail or through mail order.
• Receive prescriptions by mail in 10 business days or less.
• Refill mail-order prescriptions online or over the phone.
• Track your prescription drug history online.

When you have questions regarding your prescription drug coverage, call Washington State Rx Services at 1-888-361-1612.

Finding a Network Pharmacy
Washington State Rx Services’ pharmacy network includes most pharmacies in Washington State as well as national chains. Use the Pharmacy Locator tool or call Washington State Rx at 1-888-361-1612 to see if your pharmacy is in the network.

Ordering Prescriptions through Mail Order
Wellpartner is Washington State Rx Services’ mail-order pharmacy. To order a new prescription by mail, your provider can fax in a prescription or you can mail in the written prescription using Wellpartner's order form [PDF] . To order refills, call 1-800-815-3539 or order through your online pharmacy account (available to enrollees January 1, 2008).

What Drugs Are Covered? The Washington State Rx Preferred Drug List
The Washington State Rx Preferred Drug List (PDL) is a list of prescription drugs covered under your prescription drug benefit. By looking at the PDL, you can find out:

• The drug tier level.
• If the drug must be precertified.
• If there are any limits on its coverage.
• Whether there are less expensive alternatives.

How Much Will I Pay for Prescription Drugs?
The following table shows the copay for each drug tier. You can find the tier for your prescription drug by checking the Washington State Rx PDL or by calling
1-888-361-1612.

If the drug costs less than the copay, you pay the lower cost. You can fill a prescription for up to a 90-day supply at retail, but you will pay three copays – one copay for each 30-day supply.

Ancillary Charge: You May Pay More for Tier 3 Drugs With a Generic
If a Tier 3 drug has a generic equivalent, you pay the Tier 1 copay plus the difference between the cost of the brand-name drug and its generic equivalent.

If you don't know if your Tier 3 drug has a generic equivalent, call Washington State Rx Services at 1-888-361-1612 or check the PDL. Generic drugs have the same active ingredient as the more expensive brand-name version. Ordering generic drugs may save money for you and the plan.

Should I Buy My Prescriptions at Retail or Through Mail Order?
Prescriptions are limited to a 30-day supply at retail. You can purchase up to a 90-day supply at retail, but you must pay three copayments. So if you need more than a
30-day supply, you should consider using the Wellpartner mail-order pharmacy. If you take a maintenance medication on a continuing basis, you’ll save money when you buy a 90-day supply through mail order.

How Do I Order Specialty Drugs?
You must order your specialty medications by mail order from BioScrip by calling 1-877-316-8921 (24 hours a day, 7 days a week). Most specialty drugs require preauthorization. A patient care coordinator will contact your provider to review the coverage criteria and authorize the prescription if the criteria are met. The patient care coordinator will then work with you to schedule a delivery time and place for the medication.

Access Your Pharmacy Account
Order drugs online or check your drug history

Pharmacy Locator Tool

Preferred Drug List (formulary)
Check what drugs are covered

Prescription Price Check Tool
If you have other coverage that is primary, your out-of-pocket costs may be different.

Mail-Order Pharmacy Form (PDF)
Use this form to order drugs from the Wellpartner mail-order pharmacy.

Prescription Drug Coverage Claim Form (PDF)
Use this form to be paid for drug purchases at non-network pharmacies or when Aetna is your secondary plan.