Get a Refund for Covered Drugs and Services

IEHP covers medicine and medical services, please check your IEHP Member Handbook for a list of covered benefits and services. If you find that you paid out of pocket for medicine or services that should have been covered by IEHP, you may request to get a refund. To request a refund follow the steps below.

Before you submit a request for refund:

  1. The request for refund must be submitted within 1 year from the date of service.
  2. All requests will go through a 30 day review process based on medical need and the reason for the request.
  3. IEHP does not promise refunds for medicines that are not covered by IEHP (see a list of covered medicines).
  4. For medicine not covered by IEHP, a Pharmacy Exception Request form must be submitted. If this process is not followed IEHP may deny all future requests for refunds.

How to submit a request for refund:

  1. Fill out and sign the IEHP Pharmacy Reimbursement Request Form (Medi-Cal) (DualChoice)
  2. Attach a copy of the cash register receipt and a copy of the pharmacy print out (given to you by the pharmacist).
  3. The pharmacy print out must have:
    • Pharmacy name, address, phone number
    • Medicine name, quantity, strength and form
    • The National Drug Code (NDC)
    • Date of service
    • Total amount paid
    • Doctor’s full name
  4. You will be notified by mail of IEHP’s decision.

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