If you urgently need a medication filled during our nonbusiness hours, the pharmacy may do a one-time override known as an emergency fill for up to a 7-day supply. Types of medications that qualify for emergency fill include:
- Asthma and COPD
- Antibiotics, Antivirals, and Antifungals
- Anticoagulation and Antiplatelet
- Antirejection and Immunosuppression
- Antidiabetic (including insulin)
- Blood Glucose Test Strips
- Cardiovascular (antihypertensive, antiarrhythmic, diuretics, nitrates)
- Epinephrine Injections
- Seizure and Epilepsy
- Mental Health (including antidepressants)
- Acute Migraine Treatment
If you need to fill an urgent prescription that requires step-therapy or PacificSource’s prior authorization during nonbusiness hours, please visit an in-network pharmacy. A one-time override is called an “emergency fill” and can be done at an in-network pharmacy if the following conditions are met:
- You are currently enrolled in a PacificSource group or individual and family health plan in Washington.
- Waiting for the medication would result in imminent emergency care, hospital admission, or might seriously jeopardize your life or health or others who are in contact with you.
- The medication is eligible for emergency refills.
- You make the request through an in-network pharmacy.
- If you need more medication beyond the emergency fill, subsequent refills will need to be reviewed through PacificSource’s standard prior authorization process.
- The medication indication and dosage must be within FDA approved limits.
You will receive:
- No more than the prescribed amount up to a seven-day supply; or
- The minimum packaging size available at the time the prescription is dispensed.
Cost sharing for an emergency fill will cost your standard copay, coinsurance, or the cost of the drug, whichever is less. The deductible, if any, will still apply.