Catastrophic Coverage Reimbursement
This article applies to participants who have a Via Benefits reimbursement account (sometimes known as a Health Reimbursement Arrangement)*.
Catastrophic Rx coverage is an added benefit provided by some former employers or benefits providers. It assists you with prescription costs if you reached the catastrophic phase of your Medicare Prescription Drug plan. Your former employer may require you be enrolled through Via Benefits Insurance Services to activate this benefit.
Good news! Beginning January 1, 2024, you won’t need to pay a copay in the catastrophic coverage phase of your prescription drug plan due to the Inflation Reduction Act of 2023. You can still get reimbursed for catastrophic prescription expenses you incurred before January 1, 2024, and you will have between 3 and 12 months in 2024 to submit those expenses. The Via Benefits website displays a message with your specific expense submission deadline.
To access catastrophic coverage funding, you must:
Reach the catastrophic coverage phase of your Medicare Prescription Drug plan. Your prescription drug insurance carrier notifies you when you reach this level.
Call us at 1-866-322-2824 (TTY: 711) to request a Catastrophic Coverage Reimbursement Request Form.
Fill out and submit the reimbursement request form.
Include all of the pages of the Explanation of Benefits (EOB) from your Medicare Prescription Drug plan showing you have reached the catastrophic coverage threshold to initiate the account.
After initiating the account, you can submit additional EOBs for reimbursement of additional prescription expenses.
You can also hold all monthly EOBs and submit them at one time at the end of the year.
A separate account is established for each qualified participant. Your account is based on your name and Social Security number.
Spouses can't file claims against any account other than their own.
Your catastrophic coverage reimbursement account isn't part of any regular reimbursement account.
*Via Benefits reimbursement accounts are administered by Extend Health, LLC.