Members

The BeneCard PBF Member Portal gives you easy, secure access to helpful member tools.

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Pharmacy Locator

Search our network of providers to find a pharmacy near you. Please note that some pharmacies found in the general network may not be participating in your group’s program.

If you don’t have login credentials and/or are not enrolled in BeneCard PBF, click here to view our general pharmacy network. If you would like to view the network that is specific to your plan and have login credentials, please click here to log in and then click on pharmacy locator.

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Member ID Card

Your member identification card provides you access to your BeneCard PBF benefits. Log in to the Member Portal to get your member ID.

Clinical Review

Some medications require a Clinical Review to check for potential safety issues. During the review, our pharmacists will look at the medication you’ve been prescribed along with your unique health profile. This includes the diagnosis the medication is intended to treat, other medications you may be taking, and any other health conditions you may have.

FDA Guidelines

Our pharmacists adhere to the account guidelines issued by the U.S. Food and Drug Administration (FDA) and the medication’s manufacturer. These guidelines contain information on safe and effective use, such as appropriate dosing, age limitations, and important warnings and contraindications.

Track Your Review

You can track the Clinical Review process online through the Member Portal and sign up for email alerts. This can even help you reach out to your prescriber to find out if they have received any requests for information from BeneCard PBF, and if they’ve had a chance to respond to the inquiry.

Drug Pricing

Our drug pricing tool allows you to check costs at network pharmacies. You can also review your plan’s copay structure in the Member Portal or contact Member Services for assistance.

FAQs

What is a pharmacy benefit manager?

Pharmacy benefit managers were created in the 1970s to handle the administrative aspects of prescription drug coverage. Over time, they began to offer clinical programs aimed at patient safety and negotiated with drug manufacturers to obtain better prices on prescription drugs for consumers.

BeneCard PBF was founded on the basis of clinical excellence. We’re here to put your health and safety first. We also work closely with pharmacies, prescribers, and plan sponsors – your benefit providers – to provide you with the most effective care at the best value.

How does my prescription plan work?

When you receive a prescription from your physician, present it along with your BeneCard PBF member card at the participating pharmacy of your choice. If your prescription is covered, you’ll be asked to pay a copayment as required by your plan. Your plan sponsor will pay the remaining cost of your prescription.

How do I know if my prescription is covered by my benefit?

BeneCard PBF releases updated formularies (a list of covered drugs) twice a year. Updates typically take effect in January and July. You can access your plan’s formulary by logging into the online Member Portal. You can also call Member Services (1-888-907-0070) for help obtaining a hard copy of the formulary or if you have formulary questions.

Please note that the inclusion of a product on the formulary does not guarantee coverage in all cases. The product may be subject to Clinical Review or other specifics of your plan design for coverage. Learn more about Clinical Reviews below.

How do I find a participating pharmacy?

Most pharmacies participate in the BeneCard PBF network. You can easily locate a nearby participating pharmacy by using the pharmacy locator tool in the Member Portal or our mobile app, or by calling Member Services (1-888-907-0070).

What if I lose my card or need an extra one?

Notify the benefits manager at your organization immediately if you lose your card or need a duplicate. A new card can be issued within a few days. Your plan may also allow you to access a temporary copy of your member card online through the Member Portal or mobile app.

If you have used your BeneCard PBF card at a pharmacy before, they may have your information on file in their computer system. If so, you’ll only need to present your prescription and your personal identification, such as your driver’s license. If you’re having any problems getting your prescription filled, call us directly at 1-888-907-0070.

You can also pay the cash price for the prescription and file a reimbursement form later. However, depending on your plan design, the medication may cost more even after reimbursement than what you would have paid with your member card.

What happens when I submit my prescription to the pharmacy?

When you submit a prescription to your pharmacy, the pharmacist will process it through the BeneCard PBF claims system to see if it’s covered by your prescription benefit plan. At the same time, the claims system will look for any safety precautions. If it identifies any concerns, it will alert the pharmacist.

Sometimes the pharmacist can resolve the issue simply by calling your prescriber to discuss the best course of action. We make sure they have the relevant information they need to work with your prescriber to find the best treatment for you.

Other times, your prescription may need to be reviewed by BeneCard PBF’s pharmacists as part of our clinical programs. Find out more about Clinical Reviews below.

What is a Clinical Review? How does it work?

Some medications require a Clinical Review to check for potential safety concerns. During the review, our pharmacists will look at the medication you’ve been prescribed along with your unique health profile. This includes the diagnosis the medication is intended to treat, other medications you may be taking, and any other health conditions you may have. 

Our pharmacists also take into account guidelines issued by the U.S. Food and Drug Administration (FDA) and the medication’s manufacturer. These guidelines contain information on safe and effective use, such as appropriate dosing, age limitations, and important warnings and contraindications.

If we need more information to assess medication safety and appropriateness, our pharmacists will reach out to your prescriber. You can track the Clinical Review process online through the Member Portal and sign up for email or text alerts. This can even help you reach out to your prescriber to find out if they have received any requests for information from BeneCard PBF and if they’ve had a chance to respond to the inquiry.

How much will my prescription cost?

The cost of prescriptions can vary depending on your copay structure and which pharmacy you use. Our drug pricing tool allows you to check costs at network pharmacies. To access the tool, simply log into your member account through the Member Portal or our mobile app. You can also review your plan’s copay structure in the Member Portal or by calling Member Services (1-888-907-0070) for assistance.

The inclusion of a product in the drug pricing tool does not guarantee coverage. The product may be subject to Clinical Review or other factors for coverage.

Where can I learn more about my prescription plan?

You can find plan information such as the formulary (a list of covered drugs), copay structure, and information on participating network pharmacies in the Member Portal. To access the portal, you’ll need a member account. You can learn how to set up an account here.

In addition, you can contact Member Services (1-888-907-0070) at any time with questions about your prescription benefit. Your benefits office or human resources team may also be able to assist you.