Orlando Harmon
Elixir Insurance is a Medicare Part D prescription provider that offers a range of prescription benefits to individuals and group retirees. As a subsidiary of the pharmacy chain Rite Aid, Elixir Insurance has been providing quality prescription drug plans at affordable prices. However, Elixir Insurance has recently been the subject of complaints and legal troubles, including allegations of failing to provide advance notice of premium increases and issues with coverage of lost, stolen, or damaged medications. With a focus on improving the pharmacy care experience, Elixir Insurance provides convenient access to a nationwide network of pharmacies and various options for obtaining medications, including mail-order services.
| Characteristics | Values |
|---|---|
| Type of Insurance | Medicare Part D |
| Area of Focus | Prescription Benefits |
| Parent Company | Rite Aid |
| Coverage Determination | Fax authorization or coverage determination forms to 1-877-503-7231 |
| Coverage Determination (cont.) | Submit electronic requests or call 1-866-250-2005 (TTY 711) |
| Coverage of Lost/Stolen/Damaged Medications | Not covered except in limited situations |
| Annual Notice of Change | Required by CMS, must be sent to all applicable members |
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What You'll Learn
- Elixir Insurance is a Medicare Part D prescription provider
- Elixir Insurance is a subsidiary of Rite Aid
- Elixir Insurance provides prescription benefits to individuals and group retirees
- Elixir Insurance has received complaints about premium increases
- Elixir Insurance is no longer offering plans in Puerto Rico
Elixir Insurance is a Medicare Part D prescription provider
Elixir Insurance's Part D plan provides prescription drug coverage to enrolled Medicare beneficiaries. The company partners with national healthcare companies to provide medications and offers a range of pharmacy options, including large, well-known national chains, independent local pharmacies, and mail-order services.
Elixir Insurance is committed to making the coverage determination and appeals process as easy as possible for its members. It provides a Member Portal where individuals can log in to find ways to save, review their coverage, and locate a network pharmacy. The company also offers a range of tools to help make medications more affordable, such as a drug pricing tool to find lower-cost alternatives and low copays.
As a Part D plan sponsor, Elixir Insurance must adhere to the rules and regulations set by the Centers for Medicare and Medicaid Services (CMS). This includes submitting annual reports on rebates and other remuneration received from drug manufacturers in connection with the Part D drugs provided to beneficiaries.
While Elixir Insurance has been a long-time provider of Medicare Part D plans, the company recently announced that it will no longer offer individual Medicare prescription drug plans effective January 1, 2024. This decision has led to Elixir Insurance discontinuing its business in Puerto Rico, where it supported Medicare Part D programs for several health plan companies.
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Elixir Insurance is a subsidiary of Rite Aid
Elixir Insurance Company is a subsidiary of Rite Aid, a U.S.-based pharmacy chain. Elixir Insurance was previously known as Envision Pharmaceutical Services, which Rite Aid acquired in 2015 for $2 billion. In 2020, Envision rebranded as Elixir to integrate its pharmacy benefits, services, and technology companies.
In 2024, Elixir Insurance Co. announced its plans to discontinue business in Puerto Rico on December 31, 2024. The company asked the Puerto Rico Office of the Insurance Commissioner (OCIF) to approve the surrender of its authority to operate as an insurance company in the territory. The number of Elixir Insurance subscribers in Puerto Rico is unknown.
In 2025, the Rite Aid Corporation and its subsidiaries, including Elixir Insurance Company, RX Options LLC, and RX Solutions LLC, agreed to pay $101 million to resolve allegations of falsely reporting rebates. The United States Department of Justice stated that Rite Aid and its subsidiaries violated the False Claims Act (FCA) by failing to accurately report drug rebates to the Medicare Program. Specifically, U.S. Attorney Rebecca C. Lutzko alleged that Rite Aid and its Elixir subsidiaries retained millions of dollars in manufacturer rebates that should have been reported to Medicare under Part D.
Medicare Part D involves private entities, known as Part D Plan Sponsors, offering and administering insurance plans that provide prescription drug coverage to enrolled Medicare beneficiaries. These sponsors must submit annual reports to the Centers for Medicare and Medicaid Services (CMS), disclosing information about rebates and other remuneration connected to the Part D drugs provided. This ensures that the government benefits from any price concessions offered by drug manufacturers.
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Elixir Insurance provides prescription benefits to individuals and group retirees
Elixir Insurance is a Medicare-approved insurance company that provides prescription benefits to individuals and group retirees. Elixir Insurance is part of the Elixir and Rite Aid family of companies, which are integrated with national healthcare companies. This integration allows Elixir Insurance to provide its members with convenient access to a nationwide network of thousands of pharmacies.
Elixir Insurance offers a Medicare-approved Part D plan, which helps hundreds of thousands of people across the nation get the medications they need at affordable prices. The company has a unique ability to provide great coverage at a low monthly premium. Elixir Insurance also maintains 100% United States-based member service, which is available 24 hours a day, seven days a week.
Elixir Insurance's Medicare Part D plan does not generally cover lost, stolen, or damaged medications, except in limited situations. For instance, in the case of a complaint filed with the Better Business Bureau, Elixir Insurance advised the complainant that they would need to provide either a Fire Department report or a Home Insurance claim to satisfy the request for coverage of medication lost in a house fire.
Elixir Insurance is committed to making the coverage determination and appeals process as easy as possible. Members can fax authorization or coverage determination forms, submit electronic requests for coverage determination, or call for assistance. The company also provides a covered drugs or drug pricing tool that members can use to find lower-cost alternatives for their prescriptions.
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Elixir Insurance has received complaints about premium increases
Elixir Insurance is a Medicare Part D insurance provider. The company has received numerous complaints about unexpected premium increases. Many customers have reported that their monthly premiums have tripled or doubled without any prior notice. This has resulted in customers paying significantly more for their insurance coverage, with some reporting that their coverage costs have increased by over 50%.
In response to these complaints, Elixir Insurance has stated that they notified customers of the premium increases in advance. However, several customers have disputed this claim, stating that they did not receive any notification of the changes. This discrepancy has led to frustration and dissatisfaction among customers, who feel that the company is taking advantage of them, particularly seniors who may have limited options for changing plans.
The Better Business Bureau (BBB) has also received complaints regarding Elixir Insurance's premium increases. In one case, a customer reported that their monthly premium increased from $20.30 to $64.90, and despite contacting Elixir, they were told that nothing could be done as the open enrollment period had already closed. Another customer reported a similar issue, with their monthly premium increasing to $60.10, and expressed concern that the company was taking advantage of seniors by implementing these increases.
Elixir Insurance has a grievance process in place to address customer complaints. Customers can submit grievances related to various issues, including premium increases, within 60 days of the situation occurring. However, some customers have reported that their grievances were not adequately addressed or that they did not receive a satisfactory response from the company.
The premium increases, coupled with the lack of notification and perceived incompetence or greed, have led to dissatisfaction and frustration among Elixir Insurance customers. The company's response to these complaints has been varied, with some customers reporting that Elixir Insurance was unable to resolve their issues.
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Elixir Insurance is no longer offering plans in Puerto Rico
Elixir Insurance, a subsidiary of Rite Aid, is no longer offering plans in Puerto Rico. The company specialises in Medicare Part D prescription services, partnering with national healthcare companies to provide medications. However, as of 30 June 2024, Elixir Insurance's certificate to operate in Puerto Rico became inactive due to the non-renewal of its certificate.
This development marks a significant change for Elixir Insurance, which was established through Rite Aid's acquisition of Envision Pharmaceutical Services in 2015 for $2 billion. In 2020, Envision rebranded as Elixir to integrate its pharmacy benefits, services, and technology offerings. While the company has a presence beyond Puerto Rico, the impact of its withdrawal from the Puerto Rican market is unclear, as there is a lack of information about the number of subscribers the company has in the region.
The Office of the Insurance Commissioner of Puerto Rico (OCIF) commented on the situation, stating that they had a pending name change request from Envision Insurance Company to Elixir Insurance Company. However, Elixir Insurance did not respond to follow-up communications or submit a withdrawal request for its certificate. As a result, its certificate became inactive as of 30 June 2024.
Elixir Insurance's departure from Puerto Rico raises questions about the continuity of Medicare Part D programs that were supported by the company in the region. It is unclear whether alternative providers will fill the gap left by Elixir Insurance's exit, and how this change will impact the availability and affordability of prescription medications for residents of Puerto Rico.
While the reasons behind Elixir Insurance's decision to not renew its certificate in Puerto Rico are not publicly known, there have been past allegations of improper reporting of rebates received from manufacturers as bona fide service fees. These allegations were levelled against Elixir Insurance and other defendants between 2014 and 2020. Despite this, Elixir Insurance continues to serve customers outside of Puerto Rico, offering prescription benefits, a member portal, and resources to manage their coverage and medication needs.
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Frequently asked questions
Elixir Insurance is a Medicare-approved Part D plan provider. It is a subsidiary of the U.S.-based pharmacy chain Rite Aid.
Elixir Insurance provides prescription drug coverage to Medicare enrollees. It offers a range of pharmacy options and helps make medications more affordable for its members.
Yes, Elixir Insurance is a Medicare Part D plan provider. It is, however, a private entity known as a Part D Plan Sponsor that offers and administers insurance plans for Medicare beneficiaries.
You can fill or refill prescriptions by mail through BirdiRx. You can also track the status of your order, transfer prescriptions, and view your medication history.
You can submit a coverage determination form to Elixir Insurance by faxing it to 1-877-503-7231 or by calling 1-866-250-2005 (TTY 711) for assistance.
