Most Major Insurance Plans Accepted | Bald Mountain Pharmacy | 248-607-0205

We accept many insurance plans and are adding more every day!

We work with many major insurance plans and continue adding more to help patients access affordable prescription care in Michigan. If your plan is not currently contracted, our team can help review pricing options and answer coverage questions with transparency and personalized support.

Insurance Made Simple

Patient Information

Full Name

Date of Birth

Phone Number

Email Address

Home Address

Primary Insurance Information

Insurance Provider Name

Policy Holder Name

Secondary Insurance Information

Do You Have Secondary Insurance?

Yes

Secondary Insurance Provider Name

Prescription & Pharmacy Preferences

Preferred Prescription Notifications

Text Messages

Phone Calls

Email Notifications

Would You Like Automatic Refill Reminders?

Yes

Authorization & Consent

I authorize the pharmacy to verify my insurance coverage and process prescription claims on my behalf.

I acknowledge that I have received or been offered access to the pharmacy’s Notice of Privacy Practices.

I consent to receive pharmacy-related communications regarding prescriptions, insurance updates, refill reminders, and healthcare notifications.

Electronic Signature

Patient Signature

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I consent to the collection, use, storage, and processing of my personal and, where applicable, health-related information, including any data I submit on behalf of others, for the purpose of evaluating or fulfilling my request made through this form. I understand this will be handled in accordance with the Privacy Notice.

Proudly serving Lake Orion and the surrounding communities.

Call Now !

Call us to see if your insurance is accepted yet.

Fair. Transparent. Cash Pricing.

Competitive prices on common medications
No hidden fees
We help you find the most affordable option

Don’t have insurance? No problem.

We’ve got your back.

Give us a call to learn more about our cash pricing.

Insurances