Register

800-771-4648

BIN: 800004

Rx Group ID: 99999999

Group Name: ABC Company

Cardholder ID: 234312312

Cardholder Name: JOHN TEST

Username Requirements:
Usernames must be between 5 and 30 characters, contain no spaces and include only letters, numbers or approved special characters ( @ . - _ )

Password Requirements:
Passwords must be at least 8 characters in length, contain no spaces and include only letters, numbers or approved special characters ( ! @ # $ ^ & ( ) _ )

HIPAA Regulations -- Spouse:
The HIPAA privacy regulations generally restrict MedImpact from displaying prescription information about your spouse, except in very limited circumstances, since your spouse is the owner of her/his Protected Health Information. If you have any questions about these restrictions, please feel free to call us to speak directly with one of our Pharmacy Benefit Advisors at 800-771-4648.

HIPAA Regulations -- Dependents:
The HIPAA privacy regulations generally restrict MedImpact from displaying prescription information about emancipated minors over the age of 18, even if they are your dependents, unless you are the legal guardian / personal representative. If you have any questions about these restrictions, please feel free to call us to speak directly with one of our Pharmacy Benefit Advisors at 800-771-4648.

Member Registration

Existing Members log-in here.

Don't have an account? Signing up is quick and easy!

*All fields are required

Personal Information

Cardholder ID

Your Birth Date

Your First Name

Your Last Name

Email Address

Account Information

Username

Password

Confirm Password

Protecting Your Information

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have the right to view protected health information (PHI) that pertains to you or a legal dependent. (PHI is "any information that identifies an individual and relates to an individual's past, present or future physical or mental health condition, health care treatment, or payment for health care services".) MedImpact maintains PHI in the form of prescription claims histories.

Under HIPAA privacy regulations:

You may only have access to your prescription information (i.e. claims history) and dependents under 18 on your plan.
You cannot view information about your spouse unless they have granted you permission.
You cannot view children over 18 unless they have granted you permission.

You are about to view prescription claims information across a secure site. You, the recipient, are obligated to maintain this information in a safe, secure and confidential manner. Unauthorized re-disclosure or failure to maintain confidentiality could subject you to penalties described in federal or state law.

Please type your initials below to indicate that you've read and understand this statement.

Your Initials

Need Help? Contact a Pharmacy Benefit Advisor at 800-771-4648.