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Pharmacy Network

SXC provides a network of over 48,000 available pharmacies in the U.S., and over 2,100 located in Michigan. You can have your prescriptions filled at any network pharmacy by showing your prescription drug plan ID card to the pharmacist. The pharmacist electronically sends your ID number and prescription details to SXC and receives back:

  • Verification of your participation as a U-M member in the drug plan.
  • The co-pay or co-insurance amount you need to pay for your prescription.
  • The discounted amount SXC pays for the prescription plus the dispensing fee to the pharmacist.
  • Any electronic safety edits or warnings the pharmacist needs to know, or when the pharmacist needs to contact your physician about your prescription.

The University of Michigan custom network includes over 95% of the pharmacies in Michigan, including most major pharmacy chains. The University of Michigan Health Services Pharmacy, University of Michigan Ambulatory Care Pharmacy (in the Taubman Center), the Cancer Geriatric Center Pharmacy (in the CGC), and the East Ann Arbor Health Center Pharmacy participate in the SXC pharmacy network. A state and national pharmacy locator of over 48,000 available pharmacies can be found at: https://umi.rxportal.sxc.com or by calling the SXC toll-free number 866-715-0874 (TTY 866-261-0791).

You do not have to file claim forms or wait for reimbursement when you use your University of Michigan prescription drug ID card a participating network pharmacy.

Finding a Network Pharmacy
There are a number of ways to find out if a pharmacy will accept your SXC ID card.

To find a participating pharmacy anywhere in the U.S.:

    • Review the pharmacy locator on the https://umi.rxportal.sxc.com Web site, or
    • Call the SXC toll-free number 866-715-0874.
    • To determine if a specific pharmacy participates in the SXC Network:
      • Call the SXC toll-free number 866-715-0874 , or
      • Call the pharmacy directly.

If the pharmacy you use is not in the SXC network, contact SXC and ask to have your pharmacy added to the network.

Retail Pharmacy Benefit
When you present your SXC ID card at a participating pharmacy, the pharmacist will be able to tell you the amount of your share of the cost for each prescription. You are eligible to receive up to a 90-day supply for each prescription obtained at a participating pharmacy.

Using Non-Network Pharmacies
If you have your prescription filled at a pharmacy that does not participate in the SXC network, you will have to pay the full cost of the drug and file a claim with SXC for reimbursement. Claims must be filed within 90 days of fill. Older claims will not be reimbursed. Non-network reimbursement is limited to a 34-day supply. You will be reimbursed based on the contracted price that a participating pharmacy would charge for the same drug, minus your co-pay amount. The plan will not reimburse costs exceeding the contracted price. This reimbursement process also applies if you do not present your SXC ID card when you have your prescription filled at a participating pharmacy.

Reimbursement claim forms are available from the Forms page. Or contact SXC Member Services to request a form.

 

Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Benefits Office reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern. The University in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. 

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