Supporting Your Clients with Pharmacy Benefits: A Broker’s Guide

At Alliant Health Plans, we know how important it is for brokers to have the right tools and resources to assist their clients. As part of our commitment to providing exceptional service, we want to remind you about the pharmacy benefits available to members through our Pharmacy Benefit Manager (PBM), Prime Therapeutics.

Who is Prime Therapeutics?

Prime Therapeutics is a trusted PBM that partners with health plans to provide cost-effective and accessible pharmacy benefits. Their focus on affordability and member well-being ensures that Alliant members receive the best possible support for their prescription needs.

How Brokers Can Assist with Pharmacy Benefits

When reaching out to Prime Therapeutics at (844) 451-8288 on behalf of a member, the caller must verify their identity by providing the following information: 

• Their first name and the first letter of their last name 
• Client’s Broker of Record first and last name
• Client’s Broker of Record phone number 
• Agency name 

Additionally, the caller will need to provide three member identifiers to proceed with the call:

• Member Name (required)
• Two of the following:
  • Date of Birth
  • Member ID
  • Member Address (partial is acceptable, e.g. street address or ZIP code)

What Information Can Brokers Request?

Brokers can access valuable details regarding a member’s pharmacy benefits, including:

• Medication Price Quotes – Get details on drug cost, copay, coinsurance, deductible, tier level, and out-of-pocket max (excluding member-specific accumulator amounts).
• Eligibility Status – Verify eligibility and coverage dates.
• Pharmacy Network Information – Confirm preferred pharmacies and their network status.
• Prior Authorization (PA) Requirements – Determine if a PA is needed and check the status of a PA or coverage requests.
• Claim Status – Completion of payment.
• Processing Information – Limited processing information that includes group, BIN, and PCN information.

We’re Here to Help

At Alliant Health Plans, we’re committed to making pharmacy benefits as seamless as possible for our brokers and members. By understanding these key details, you can better serve your clients and ensure they have the support they need.

For additional assistance, feel free to contact your Alliant Account Executive. We appreciate your partnership and the role you play in helping members navigate their health care benefits.