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HealthPartners

Coverage criteria policies

Third party payments

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.

Administrative Process

Amounts paid by a third party administrator, such as through a copay assistance coupon program, for member liability are not eligible to be applied to a member’s deductible and/or out-of-pocket accumulators .

Coverage

When member liability is paid to a pharmacy by a third party through a Copay Assistance Coupon or other form of third party payment, the amount paid by the third party is not eligible to be applied to a member’s deductible and out-of-pocket accumulator.

Definitions

Copay Assistance Coupon is a program offered by a drug manufacturer that reduces the member liability when a member fills a prescription. Copay Assistance Coupons are also referred to as: Drug Manufacturer Savings Card, Discount Card, and Drug Rebate Card.

Third Party Payment is a payment of the member liability by an outside entity in the form of a Copay Assistance Coupon.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

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Policy activity

  • 10/09/2017 - Date of origin
  • 02/08/2017 - Effective date
Review date
  • 09/2018

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