Terms for Discount Card Network

Bartell Drugs is unable to work directly with all discount card companies for a variety of reasons. Bartell Drugs has developed a Discount Card Network comprised of discount card companies that have either contracted with Bartell Drugs directly or agreed to abide by certain terms approved by Bartell Drugs.  In instances where your prescription is not covered by insurance, Bartell Drugs will select on your behalf a discount card (“Discount Card”) from its approved Discount Card Network at the time of adjudication. As part of this selection process, Bartell Drugs will attempt to find you the best price for your prescription from among the independent, discount card companies included in our Discount Card Network at the time of adjudication. By agreeing to use Bartell Drugs as your pharmacy to fill prescriptions not covered by insurance, you authorize Bartell Drugs to select a discount card company within its Discount Card Network and understand that there may be other discount card companies outside of Bartell Drugs’s Discount Card Network that may offer a lower price on your prescription. If you want to use a discount card company outside of Bartell Drugs’s Discount Card Network to fill a prescription not covered by insurance, Bartell Drugs may not be able to fill your prescription.

Authorization to Disclose Protected Health Information to Discount Card

By proceeding with one or more discount cards (“Discount Card”) within Bartell Drugs’s Discount Card Network, you authorize Bartell Drugs to disclose your name, address, prescription, date of service and prescriber information to the selected Discount Card on your behalf. Once disclosed to the Discount Card, your information may be subject to redisclosure by the Discount Card and is no longer subject to HIPAA. It is subject to the Discount Card privacy practices available on the Discount Card website. Authorization is effective until revoked. You can revoke authorization at any time by requesting that your local pharmacy remove the Discount Card from payment for your prescription(s) or by requesting revocation in writing to Privacy Office, Bartell Drugs, P.O. Box 3165, Harrisburg, PA 17105. By revoking your authorization, you will no longer be eligible for the Discount Card price. You may request a copy of this authorization from your pharmacy or the Bartell Drugs Privacy Office.