Member Journey

Empowering Clients. Guiding Decisions. Elevating Member Journeys.

At Illuminate Rx, we provide clients with data-driven insights, trusted guidance, and flexible options, so they can make decisions that drive their pharmacy plan design and shape their members’ experience.

The member journey begins with the employer selecting the formulary, network options, and plan exclusions, which drive how the plan operates. No matter how decisions are made, one thing remains constant. Our human-led Member Services team delivers a high-touch experience that keeps members informed, engaged, and satisfied. We prioritize resolutions over call time by offering proactive, compassionate support that truly makes a difference.

Amy's doctor prescribes Skyrizi® for her plaque psoriasis. It requires a prior authorization (PA), which her doctor submits to Illuminate Rx.

Amy receives a push notification from RxBenefits that a PA has been received and is under review. She is directed to the Member Portal and registers to access her prescription history, real-time PA status updates, and digital ID card.

A pharmacist reviews her case and contacts her doctor to recommend switching to Otezla® for its lower net cost and clinical appropriateness. Her doctor agrees and sends the new prescription to her preferred specialty pharmacy.

Amy receives a text and portal update that her PA status has changed, and a new medication is approved and ready for her to fill.

Amy checks the portal and sees her prescription is being filled by the specialty pharmacy. She also sees her cost. She can contact the pharmacy directly for payment and delivery details. If she needs assistance, Member Services is just a phone call away.

Amy's medication arrives in her mailbox several days later and she begins taking her medication later.