NMCR Rx
National Medical Health Card Systems, Inc.

The NMHCRX managed retail pharmacy program produces cost savings for plan sponsors while providing members with a convenient, inexpensive way to fill prescriptions. Over 51,000 pharmacies in all 50 states and Puerto Rico participate in the NMHCRX network. The network includes national chains, local chains and independent pharmacies.  To find a retail pharmacy near you, visit the provider search.

Customizing a Network
Customizing a Network Plan, sponsors have a great deal of flexibility in structuring an NMHCRX retail pharmacy network for their plan members. A plan may offer:
  • The preferred NMHCRX network of 51,000 pharmacies.
  • A smaller, exclusive provider network which limits plan members to selected pharmacies - for example, two national chains plus certain independents. While still nationwide, this network trades wider access for lower expenses.
  • Typically, this type of network consists of 25% to 40% of the pharmacies in a specific geographic location.
  • Our customer service team assures that all plan members can conveniently reach an NMHCRX pharmacy. When necessary, we will contact pharmacies in a particular location to solicit enrollment in the NMHCRX network. If a pharmacy meets our standards, has on-line claim capability and accepts our pricing structure, it can join the network by signing and returning our contract. Our customer service department will even complete the enrollment process over the phone, allowing a new pharmacy to submit prescriptions on the same day it enrolls.
Cost Savings
NMHCRX negotiates with participating pharmacies to fill prescriptions at a substantial discount. The pharmacy also receives a "dispensing fee" negotiated by NMHCRX. For brand name drugs, the price is the lower of the pharmacy's usual and customary price or the contracted discount off the average wholesale price. For generic drugs, participating pharmacies must agree to accept the price generated from the NMHCRX maximum allowable cost (MAC) list. While pharmacies are free to purchase drugs from any manufacturer, the MAC list creates the financial incentive for them to dispense lower cost generic drugs without compromising the quality of care.

On-Line Services
Filling a prescription at an NMHCRX pharmacy could not be easier. A plan member simply presents the NMHCRX identification card and a prescription to a participating pharmacist. The pharmacist enters the ID number and prescription information into the NMHC system. In a matter of seconds, the on-line system provides these services:

Eligibility check - Verifies that the person is eligible to participate in the NMHCRX network.

Price verification - Tells the pharmacist what price to charge based on the pharmacy's contract with NMHC.