Pharmacy Benefit Information

Our Pharmacy Benefit program covers the cost of prescriptions for an injured employee’s workers’ compensation-related injury or illness with no out-of-pocket expense. The program is administered by the Mitchell ScriptAdvisor network and is accepted at most major pharmacy chains.

How the Program Works:

  • Once your workers' compensation claim is established, an information letter and prescription card will be mailed to you at your home address. If you have not received a card within two days after your claim is reported, please contact your NJM Claims Representative.

  • You should always present the prescription card and your claim number at the pharmacy when filling your workers' compensation-related prescriptions.

  • The prescription card is accepted at most pharmacies, including large retail chains. A short list of pharmacies closest to your mailing address will be listed on the information letter. To review a list of other network pharmacies, please visit the Pharmacy Locator or call 1-866-846-9279.

  • For your convenience, you may also be eligible to have your prescriptions sent to your home address. For more information, contact the Pharmacy Precert line at 609-659-6210 (1-800-232-6600, ext. 6210).

  • As of 2/25/21, NJM has adopted the Official Disability Guidelines (ODG) Drug Formulary in addition to the existing NJM excluded formulary. See NJM/ODG Formulary FAQs for more information.

  • Medications related to your work injury may require review and prior authorization by your NJM Claims Representative and/or our RN Pharmacy Precertification Team if the medication prescribed is not on formulary.

Pharmacy-Related Documents for Injured Employees and Medical Providers:

NJM Formulary FAQs - Frequently asked questions for injured workers and providers.

ODG Drug Formulary

NJM Excluded/Alternative Medications - A list of medications that are excluded from the NJM Formulary and a partial list of suggested alternative medications.

Letter of Medical Necessity - Any non-formulary medications prescribed for injured workers will require a Letter of Medical Necessity completed by your authorized, treating physician along with pre-authorization by our RN Pharmacy Precertification Team.

Pharmacy Benefit Department Contact Information:

609-659-6210 (1-800-232-6600, ext. 6210)