Coverage & Benefit Summary

Prescriptions Beta

Coverage and estimated cost, checked for you while you prescribe.

Coverage tells you what the plan allows, before you commit. The benefit check tells you what the patient pays, right before you send.

You can always finish the prescription. If a check is slow or fails, you can still send, queue, batch or print your prescription - no need to wait.

When you'll see this

These screens turn on for all practices on Wednesday, December 2, 2026. No setup is required. Your practice can turn either screen off at any time - see Prescription Coverage and Benefit Checks.

Coverage panel in Prescriptions

Payer Formulary Details via Surescripts

Appears when you select a medication.

  • Whether the medication is covered, and the copay
  • Covered alternatives from the patient's plan
  • Therapeutic alternatives
  • Coverage limits, such as quantity limits and their date ranges
  • Checks several medications on one prescription
  • Refresh, or check on demand with Get Coverage Details

CoverMyMeds screen 

Real-time prescription benefit and ePA

Appears when you send, queue, batch or print.

  • Patient's price at the selected pharmacy
  • This is the patient's actual estimated cost and is more precise than the plan copay shown earlier
  • Flags when prior authorization is required
  • Assign the ePA to a user or group; mark it urgent
  • Lower-cost options: other pharmacies, quantities or medications
  • Alerts from the plan for the provider
  • Send/Queue as Prescribed is always available

You control it. You don't have to wait for the coverage and benefit details to return - your send prescription controls work just as they always have. We also provide your practice with related Company Setting to control your practice experience. See Prescription Coverage and Benefit Checks to learn more.