Eligibility and plan benefits are determined at the time of service or upon receipt of a claim.
During academic breaks, the claims administrator may be unable to confirm a student's eligibility prior to receipt of spring, fall or summer eligibility information.
Claims incurred within the first four weeks of the semester, before eligibility is received, can be paid out-of-pocket or a manual update can be requested. Details below.
2016-17 Prescription Benefits
In-network prescription drug benefits for covered medications has been changed from Express Scripts to Magellan Rx Management for plan year 2015-16. Magellan Rx is a nationwide prescription drug benefit manager.
Claims incurred within the first four weeks of the semester, before eligibility is received, can be paid out-of-pocket or a manual update can be requested.
Request Manual Update
To request a manual update of SHIP eligibility during the first four weeks of the semester, send an email to email@example.com stating your intention to remain enrolled in SHIP for the semester of your request (fall or spring). Include your full name, student identification number and the name of the pharmacy you are using. The information will be forwarded to the claims administrator for updating. An email notification will be sent to your Vandal email when processing is complete and you can fill your prescription.
We will provide a general description of benefits only. It is not a guarantee of payment. Benefits are based upon the master policy, medical necessity and the patient's eligibility at the time of service. If the participant chooses a brand name drug when a generic drug is available for new prescriptions and/or refills, the co-pay for the generic equivalent plus the difference in cost between the generic and brand name drug will be applied.
If the insured chooses to pay for the prescription out-of-pocket, claim forms must be submitted to Magellan Rx. Download Magellan Rx Claim Form »
Send claims to:
Magellan Rx Management
4801 E Washington St., Suite 100
Phoenix, Arizona 85034
After the first four weeks of the semester, claims may be made at any network pharmacy with a Healthcare coverage/Rx insurance card. Cards will be sent to SHIP enrollees by regular mail. Additional copies may be requested by contacting AmeriBen at (800) 953-1801. Locate in-network providers »
Insured individuals are required to pay the full price of prescriptions purchased from non-participating pharmacies. Claims for reimbursement can be submitted to:
PO Box 7186
Boise ID 83707
Reimbursement is calculated according to the network price, so total out-of-pocket cost may be greater than the co-payment paid to an in-network pharmacy. For faster claims processing, provide insured student's social security number and UI Group #0805014.