Phoenix Rx Sharing

This is an optional, paid add-on. It is not part of the base Phoenix membership and not part of a CoreMed membership. If you have not bought it, none of the limits on this page apply to you. Ask us whether you have it.

What you pay

Five tiers. The first fill of a prescription can generally be retail for up to 30 days, and ongoing maintenance medication generally has to move to the approved mail-order pharmacy after that, where you get up to 90 days at a time.

Tier 1a is the one worth knowing about: roughly 800 commonly prescribed generics at $5, retail or mail order, either way.

The sharing credit on top

For eligible Tier 1, 2 and 3 medication, you pay the member cost above and then a sharing credit can go toward the rest of the price:

Anything above the credit is yours. Phoenix’s own worked example, for a Tier 2 retail medication with a $500 price:

At that point Phoenix may help find a cheaper version, a different pharmacy, or a manufacturer assistance program. That is worth asking for rather than waiting to be offered.

Rules that change what you get

• Tier 1a is roughly 800 commonly prescribed generics on the Phoenix formulary, at $5 whether you fill at retail or by mail. The list changes as pricing and availability change.
• The first fill of an eligible prescription can generally be retail, up to 30 days. Ongoing maintenance medication generally has to move to the approved mail-order pharmacy after that, where you can get up to 90 days.
• Specialty medication has no fixed member cost. You may have to go through Rx Care Coordination before it is eligible at all.
• International sourcing, when it is used: you pay the first $100, then up to $750 may be shared. It has to be arranged through Phoenix. Buying abroad on your own and sending in the receipt does not work.
• Prescription assistance programs may have a participation fee, generally $50 to $100, and that fee is yours.
• Call before you fill anything expensive. Skipping required coordination can reduce or wipe out what gets shared.

What it does not share

• Over-the-counter medication
• Vitamins and supplements
• Anything without a valid prescription
• Cosmetic or lifestyle medication
• Medication off the formulary
• Medication bought outside the approved pharmacy or sourcing arrangements when coordination was required
• Anything above the applicable benefit credit
• Experimental or investigational medication

It runs separately from your medical sharing

• What you pay for a prescription does not count toward your IUA.
• A prescription does not generally create a medical need on its own.
• The Rx limits run independently of the medical sharing limits.
• You need the base Phoenix membership to have this add-on, and dropping the add-on does not end the membership.

How this compares with Zion

Zion sells a pharmacy discount as an add-on too, on its own terms. CoreMed offers both sharing communities and does not steer between them.

CoreMed Rx, the pharmacy benefit in a Primary membership →
Zion and Phoenix side by side →

Phoenix HealthShare is not health insurance. Membership does not create an insurance contract or guarantee payment of any medical expense. Members remain ultimately responsible for their own medical expenses. Sharing is voluntary and governed by the Phoenix Member Guidelines. Questions about eligibility, sharing, Care Coordination or a bill go to Planstin on 435.571.0011 or Individual@Planstin.com.