Pharmacy
Prescription medicine coverage is part of your HMO with HMO Flex rider. Where you choose to have your prescriptions filled will determine how much you pay for your medicines. Choose from Kaiser Permanente pharmacies and non-Kaiser Permanente pharmacies. You can fill a limited number of prescriptions at pharmacies outside of Kaiser Permanente.
Prescriptions through Kaiser Permanente pharmacies
You can fill prescriptions (written by any provider) at Kaiser Permanente and Affiliated Pharmacies. You will generally pay the lowest out-of-pocket costs at these pharmacies.
Choose how to get your prescriptions:
- Pick up at Kaiser Permanente medical centers and Affiliated Pharmacies. Pharmacies are located in most of our Kaiser Permanente facilities and are open during regular business hours. You can get prescriptions filled and buy over-the-counter medications and supplies at our Kaiser Permanente pharmacies. Permanente doctors can send most prescriptions electronically to the pharmacy—or you can present your prescription with your membership ID. To choose the Kaiser Permanente/Affiliated Pharmacy where you’d like to pick up your prescription, visit kp.org/facilities.
- By mail-order*. Have most refills mailed to your home.
How to request a refill for pick-up or mail-order*:
- Online: Register at org/pharmacycenter.
- By phone: Call us 24 hours a day at 808-643-RxRx (808-643-7979).
Find out what drugs are covered:
- When filling a prescription at a Kaiser Permanente pharmacy, you can check if your medication is approved by visiting the Kaiser Permanente Formulary site. Select the Hawaii region, then select the formulary from the “Small Employer Group” or “Large Employer Group” drop-down menu.
*Mail-order service is only available for prescriptions filled at a Kaiser Permanente pharmacy. We are not licensed to mail medications out of state. There are restrictions for delivery of certain medications and supplies, including but not limited to controlled medications, injections, medications affected by temperature, and medications excluded by Kaiser Permanente’s Pharmacy & Therapeutics Committee.
- You can complete 10 prescription fills at a non-Kaiser Permanente pharmacy.
- Prescriptions are not subject to the Kaiser Permanente formulary, but medications on the Kaiser Permanente formulary are recommended. (To view the formulary, go to the Kaiser Permanente Formulary site. Select the Hawaii region, then select the formulary from the “Small Employer Group” or “Large Employer Group” drop-down menu.)
- You may need to pay for prescriptions filled at non-Kaiser Permanente pharmacies in full, and then submit your receipt and copy of the portion of the prescription label that contains the drug name/prescription information to the address below for reimbursement. Once we receive the documentation, you’ll be reimbursed for the cost of the drug, minus your out-of-network (non-Kaiser Permanente pharmacy) benefit cost share.
Send required documentation (per above) to the following address:
Kaiser Foundation Health Plan, Inc.
National Claims Administration – Hawaii Claims (HMO Flex rider)
P.O. Box 378021
Denver, CO 80237-9998
How to save money on prescriptions.
You can fill prescriptions you get from any licensed provider at Kaiser Permanente and Affiliated Pharmacies, where you’ll usually pay the lowest copay.
- Just bring your prescription and your ID card to the medical center. To find medical centers, go to kp.org/facilities.
- If you are registered at kp.org, you’ll be able to order refills online or by phone and have them delivered, with no cost for postage (applies to most drugs).
- If you present a prescription for a drug that is not on the Kaiser Permanente Formulary, the Kaiser Permanente pharmacist will likely check with the prescribing physician to determine if a therapeutic equivalent from the Kaiser Permanente formulary can be substituted.
- Information will become part of your Kaiser Permanente medical record, for better-coordinated care.