Making it Right / Complaints and Grievances

At Navitus, we strive to make each member’s pharmacy benefit experience seamless and accurate. However, there are rare occasions where that experience may fall short. When this happens, we do our best to make it right.

What do I do if I believe there has been a pharmacy benefit processing error?
Start with the Customer Care number listed on the card you use for your pharmacy benefits. Customer Care can investigate your pharmacy benefits and review the issue. Most issues can be explained or resolved on the first call.

What does Navitus do if there is a benefit error?  
We make it right. If there is an error on a drug list or formulary, you will be given a grace period to switch drugs. If you have been overcharged for a medication, we will issue a refund. Typically, Navitus sends checks with only your name to protect your personal health information (PHI).

What are my Rights and Responsibilities as a Navitus member?
Your rights and responsibilities can be found at navitus.com/members/member-rights.

What if I have further concerns?
If you have a concern about a benefit, claim or other service, please call Customer Care at the number listed on the card you use for your pharmacy benefits. If you wish to file a formal complaint, you can also mail or fax: 

Address:	Navitus Health Solutions Attn: Grievance and Appeals Department PO Box 999 Appleton, WI 54912-0999
Toll-Free Fax:	855-673-6507 Attn: Grievance and Appeals Department