Prescription Drug Plan Forms and Documents

Enrollment in the U-M prescription drug plan is automatic with enrollment into any U-M health plan and does not require special forms.  Use these resources to learn more about the plan, enroll in mail order, keep track of your medications, and file claims when needed.

Prescription Drug Plan Resources

Claim Forms

    For service on or after July 1, 2020, use the following form to submit claims to Magellan Rx.

    For service through June 30, 2020, use the following forms to submit claims to MedImpact.