Member Rights and Responsibilities

The root of Navitus’ customer care philosophy is to provide consistent, knowledgeable and timely responses with a personal touch. We work to answer each question or request correctly, completely, and professionally the first time. Listening to our customers’ needs allows us to continuously enhance the customer experience. Our relentless pursuit of superior customer service is what sets us apart from our competitors.

As a Navitus member, you have certain rights and responsibilities, as outlined below.

You have the right to:

• Receive pharmacy benefit services that are available when you need them and are handled in a way that respects your privacy and dignity.
• Get the information you need about your pharmacy benefit plan. This includes information about services that are covered, services that are not covered and any costs that you will be responsible for paying.
• Have access to a current list of pharmacies in the Navitus pharmacy network.
• Have your medical information kept confidential by Navitus employees. Medical information will only be released when it’s required for your care, required by law, or necessary for the administration of your prescription drug benefit. It may also be released to support Navitus’ programs that evaluate quality and service.
• Participate in a partnership between your physician, your pharmacy, and Navitus to provide you with the highest level of medical care at the best value.
• Voice your feedback, concerns or complaints or report errors regarding your prescription drug benefit. We welcome your input and want to hear and act on this information with a polite and quick response. Ensuring quality and safe care, correcting errors, and preventing future issues are top priorities. Simply call the Customer Care number on your ID card containing pharmacy information for support.

You have the responsibility to:

• Review and understand the information you receive about your prescription drug benefit and how to use Navitus services. Please visit www.navitus.com or call Navitus Customer Care when you have questions or concerns.
• Keep informed of changes to the Navitus pharmacy network and to the coverage level of your medications.
• Present your ID card each time you receive prescriptions.
• Understand your health condition(s). Work with your health care providers to develop treatment goals that you both agree upon.
• Provide accurate, complete information to your health care providers, your pharmacy, and Navitus. This will help you get the most benefit from your prescription drug plan.
• Know what medicine(s) you take. Also know why and how to use the medication.
• Pay all co-payments, deductibles and coinsurance for which you are responsible, at the time prescriptions are obtained.
• Notify your benefits administrator as soon as possible about any changes in family size, name, address, phone number, or membership status.
• Report any wrongdoing or health care fraud to Navitus or the appropriate authorities.