Patient and Member Documents
The following documents govern your participation in the ApalyRx prescription benefit program as a member of an eligible employer health plan.
Apaly Health Inc. Platform Documents
Authorizations and Consents
The following authorizations and consents are incorporated into the Terms of Use. Your acceptance of the Terms of Use constitutes your acceptance of these documents.
HIPAA Authorization
Last updated: March 31, 2026
Authorization to use and disclose your protected health information for program participation under 45 C.F.R. Section 164.508.
Patient Consent and Acknowledgment
Last updated: March 31, 2026
Consent to prescription routing and pharmacy selection, government program acknowledgments, and program exclusivity rules.
TCPA Communications Consent
Last updated: March 31, 2026
Express written consent to receive automated calls, voice messages, and text messages from Apaly Health and program partners.
ApalyRx LLC Pharmacy Services Terms
Program Supplier Terms
These terms govern your participation in programs offered by Program Suppliers through the ApalyRx platform.
Manufacturer Terms
The following terms apply specifically to your access to each manufacturer's products through the ApalyRx program.
Dispensing Pharmacy Partner Terms
These terms govern the relationship between you and the dispensing pharmacies that fulfill your prescriptions under the ApalyRx program.
Partners with Specific Forms
The following dispensing pharmacy partners require acceptance of their own specific forms. Your acceptance of the ApalyRx Terms of Use constitutes your acceptance of these forms for any prescriptions routed to these partners.