Member Terms of Agreement for Discount Prescription Drug Plan
The discount plan organization is Agelity, Inc., 115 Broad Hollow Road, Suite 325 Melville, NY 11747, (866) 243-5489, www.Agelity.com. The discount plan sponsor is AgilityRx, Address: 115 Broad Hollow Road Suite 325 Melville NY, 11747, email: customerservice@Agelity.com, phone: 1-866-243-5489, web site: http://www.agilityrx.com.
1.
Entire Agreement: All provisions under this agreement, discount card and product descriptions constitute the entire agreement between Agelity and the member. This contract is not protected by any state life and health guaranty association. Pharmacy discounts are not available where prohibited by law.
2.
Complaints: You may file a complaint regarding the availability of contracted discounts or services or other matters relating to the program at any time by calling the toll free number on the discount card or in writing to AgelityRx address shown above in this agreement. Your complaint will be acknowledged within 5 business days. We will investigate and provide you with the results of our investigation no later than the 30 business days after we receive the complaint. If you remain dissatisfied after completing this complaint process, you may wish to contact the appropriate regulatory agency in your home state.
Illinois Residents: Agelity will provide the contact information for the Illinois Insurance Department upon request.
3.
Best Efforts: Agelity shall use its best efforts to obtain acceptance from an adequate number of pharmacies that will agree to provide discounts to the members. However, Agelity does not assume any obligation if the pharmacy network is not sufficient to serve members needs.
4.
Member Card: The member will be provided with a discount card. Discount cards may be used by all family members and are valid until canceled. The member will take the card with them to a participating pharmacy and present it to the pharmacist. There are no restrictions to providers in the Agelity network. The pharmacist will then enter the identification number printed on the card into the online computer system and the Agelity prescription discount prices are accessed. The actual cost will be the lower of the contract price, or the pharmacy's usual and customary charge that day. There are no enrollment or periodic fees. The participating pharmacy may pay Agelity a fee from amounts the pharmacy collects from the member.
5.
Cancellation rights: Since there is no enrollment or periodic fees to use this card it may be cancelled at
any time with no penalty to the member. There are no EFT (Electronic Fund Transfer) transactions or any other method of payments required by our members.
To obtain additional information and an up-to-date list of participating pharmacies by name, city, and state, you may call customer service at 1-866-243-5489 or visit our web-site at http://www.agilityrx.com.
Disclosures: This discount plan is NOT insurance or a Medicare prescription drug plan. Members are obligated to pay 100% of the prescription cost to the pharmacy at the point of sale and the plan does not pay pharmacies for prescription drugs provided to members. The plan provides prescription drug discounts to members at participating pharmacies only. Drug prices fluctuate frequently and the plan's pricing tool is for informational purposes only. No enrollment or periodic fees apply. The discount plan organization is Agelity, Inc., 115 Broad Hollow Road, Melville, NY 11747, (866) 243-5489, www.Agilityrx.com. Customer service is provided by AgilityRx, Address: 115 Broad Hollow Road Suite 325 Melville NY, 11747, phone: 1-866-243-5489, web site: http://www.agilityrx.com. For a list of participating pharmacies visit: http://www.agilityrx.com.
Discounts are not available where prohibited by law. The plan is not protected by any state Life and Health Guaranty Association. Agelity has no liability for providing or guaranteeing pharmacy services or for the quality of pharmacy services rendered. Participating pharmacies are subject to change without notice and are not available in all areas. The plan is governed by the Terms of Agreement provided at this web site.
On average, members can save 20% on brand drugs and 75% on generic drugs from the usual and customary cash price of their prescription.
This plan does not constitute minimum creditable coverage under Massachusetts law.