Get Medco By Mail Order Form - Medben

The Medco By Mail Order Form - MedBen is designed to simplify the process of ordering medications by mail. This guide provides comprehensive, step-by-step instructions to help users accurately complete the form and submit their orders efficiently.

Follow the steps to complete your Medco By Mail Order Form - MedBen online.

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. Fill in the member information section. This includes your Member ID, Group, email address, full name, mailing address (including street address, city, state, and ZIP code), and daytime and evening contact numbers.
3. Indicate whether the shipping address is different from the mailing address by checking either 'Temporary' or 'Permanent.'
4. Complete the Patient Information section for each new prescription. Include the patient's full name, relationship to the plan member, gender, birth date, and whether they have any other prescription plans.
5. Provide the order information by including your doctor’s name and phone number along with the total number of medications ordered.
6. If paying by credit card, fill in the card details including card type, credit card number, expiration date, and cardholder signature. You may also check the box to authorize future orders to be charged to your card.
7. Ensure to include any necessary refill slips along with the order form and co-payment in the provided envelope.
8. Before sealing the envelope, ensure that the Medco address is correctly positioned so it is visible through the window of the envelope.
9. Finally, save your changes, download a copy of the form for your records, or print it out to mail.

Complete your documents online today for a hassle-free prescription ordering experience.