Submit a Part D Claim to Blue MedicareRx

Sometimes when you get a prescription drug, you may need to pay the full cost right away. Other times, you may find that you paid more than expected under the coverage rules of the plan. In either case, you can ask Blue MedicareRx to pay you back by submitting a claim.

How to submit your claim

To submit a claim to Blue MedicareRx send your request for payment (claim form) and your payment receipt.

Please make a copy of your receipt for your records before you send the original.

  • Download the claim form
  • Mail completed claim form and receipts to the MedImpact Healthcare Systems, Inc. address on the form
  • Mail the completed claim form and receipts to:

If your claim is approved, you will be paid within 30 days after your request is received. You must submit your claim within 36 months (3 years) of the date you received the service, item or prescription drug.

If you need a paper copy of the claim form mailed to you, call MedImpact Healthcare Systems, Inc.

1-888-648-9622 (TTY: 711)
24 hours a day, 7 days a week

Learn more about the claims process

Read chapter 7 in your Evidence of Coverage to learn more about the Blue MedicareRx claims process and what other information we may need to process your request.