Anthem Grandfathered Rx Brand-Name Drug Settlement

Who Is Eligible?

You may be eligible to file a claim if you:

• You were covered under one of four Anthem policies: Core 5000, Tonik DN14, Tonik DN15, or RightPlan with generic prescription drug coverage. Not an Anthem plan in the broad sense. These four.
• That cover fell between 1 January 2017 and 8 May 2026.
• You personally paid out of pocket for a brand-name, single-source prescription drug.
• And the drug was denied solely because it was the brand-name product. A denial on any other ground — the prescription not being medically necessary, or the plan excluding the drug entirely — is outside this settlement.
• One more cuts across all of it: you must not already have been reimbursed. Money recovered from another health plan, a third-party payer, a disability or workers' compensation policy, group or employer self-funded coverage, or from a judgment or settlement earmarked for medical expenses, does not count as out of pocket.
• Each person files alone. Family members covered under the same policy cannot put their claims on one form, and there is no household claim.
• The $8,850 deductible refund works differently and asks nothing of you. Anyone charged all or part of that deductible for brand-name drug coverage was sent a refund automatically on 22 May 2026, with no form and no deadline.
• Note that this is a different matter from the Anthem proton beam radiation therapy settlement, which is a genuine class action, concerns cancer treatment rather than medication, and is limited to roughly 140 people Anthem named in discovery.

How Much Can You Get?

There is no fund being divided and no per-person cap published. Anthem agreed to reimburse what eligible policyholders actually paid, so the size of your payment is the size of your documented out-of-pocket spend on qualifying brand-name drugs.

That makes this unlike most settlements on this site. Nobody's share shrinks because other people file, and there is no estimated average to quote, because the amount is whatever your receipts show.

The second benefit is the partial refund of the $8,850 deductible. Members who were charged all or part of it for brand-name drug coverage were refunded automatically, by post, on 22 May 2026. Nothing was required and nothing still is.

What does not count is anything already paid back to you. If another health plan, a third-party payer, a disability or workers' compensation policy, group or self-funded employer coverage, or a settlement earmarked for medical costs has already covered the expense, it is not out of pocket and cannot be claimed again.

The practical ceiling, then, is your own record-keeping. A brand-name drug paid for in 2018 is claimable in principle, but only if you can still produce the prescription and the proof of payment. For a period running back to January 2017, that is the real limit on what most people can recover.

How to File Your Claim

You will need the Claim ID and PIN printed on the notice the administrator sent you. This settlement is not open to anyone who simply believes they qualify.

• Every claim needs three things, and the administrator is explicit that all three are required. Proof of the prescription, meaning a copy of it or written verification from your doctor or pharmacy. Proof that you paid, meaning a pharmacy receipt, a credit card statement or a cancelled check. And a signed affidavit on the claim form itself, sworn under penalty of perjury.
• The claim form came in the post. Notice and claim form packages were mailed on 8 May 2026, and the form carries a Claimant ID and Access Code you need to file online. Lost it? Download a fresh copy from grandfatheredrxsettlement.com, or ask Rust Consulting for your ID and code on 1-855-720-6806 or at info@GrandfatheredRXSettlement.com.
• Three ways to send it, all due by 10 November 2026. Upload it at the settlement website with your Claimant ID and Access Code. Email it to info@GrandfatheredRXSettlement.com. Or post it to Special Notice of Defense, c/o Rust Consulting Inc. - 9167, PO Box 2599, Faribault, MN 55021-9599.
• One form per person. If several people on the policy are claiming, each files separately, and there is a second form available if one page will not hold all your expenses.
• If the claim is rejected you get a single chance to fix it. The administrator sends a notice listing what is missing, and you have until 10 November 2026 or 30 days from that notice, whichever falls later. Miss that and the claim is refused, and there is no right of appeal.
• Late forms are not automatically dead, but they are not safe either. You may send one with a letter explaining the delay; the parties decide whether to accept it, and the administrator makes no promises.

Frequently Asked Questions