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At Navitus, we strive to make each member’s experience with their pharmacy benefits seamless and accurate. However, there are rare occasions where that experience may fall short. When this happens, we will do our best to make it right for the member.

What if I believe there has been an error in processing my prescription benefit?
Start with the Customer Care number listed on the card you use for pharmacy benefits. Customer Care can look into your pharmacy benefits and review the issue.  Most issues can be explained or resolved on the first call.
What does Navitus do when they become aware of a benefit error?  
We make it right. If there is an error on a drug list or formulary, you will be given a grace period to switch drugs. If you have been overcharged for a medication, we will issue a refund. Typically, Navitus sends checks with only your name to protect your personal health information (PHI).  

What are my Rights and Responsibilities as a Navitus member?
Your rights and responsibilities can be found here. You can also request a paper copy from Customer Care by calling the number listed on your pharmacy benefits card.

Grievances and Appeals
If you have a concern about a benefit, claim or other services, please call Navitus Customer Care listed on the card you use for your pharmacy benefits. If Customer Care is unable to resolve your concern, you have the right to ask to file a written appeal. This appeal will go to your plan or Navitus depending on your plan design. Customer Care can tell you where the appeal should be filed. If it goes to Navitus, you can mail or fax your appeal, along with supporting information from your prescriber to: 
Appeals Address: Navitus Health Solutions
Attn:  Appeals Department
PO Box 999
Appleton, WI 54912-0999
Toll-Free Fax: 855.673.6507
Attn: Appeals Department