To find a pharmacy in our network, please go to the Provider Directory and select the Pharmacy Search button.
Finding a pharmacy out of the area
Our pharmacy access exceeds Centers for Medicare and Medicaid requirements for pharmacy access in our service area. If you are a current member and need to find a pharmacy out of the area, please contact Customer Service.
Using a pharmacy out of the network
There are special circumstances when our plan will cover prescriptions from out of network providers/pharmacies.
1. Drugs may be covered for an illness while members are travelling outside of the plan’s service area and where there are no network pharmacies.
2. Part D vaccines administered in a clinic or hospital setting which are considered out of network.
If you are unable to use a network pharmacy and none of the above scenarios apply; you must have prior authorization (advance approval) from our plan to get prescriptions from an out-of-network pharmacy provider. If you pay out-of-pocket for a prescription and you feel we should cover this expense, please contact us or send the bill to us for payment review. You can find more detailed information regarding how this is done in your Evidence of Coverage in Chapter 7, section 2.1.
If you have questions need help understanding any of the information above or where to find additional information, please contact us.
This web page was updated on September 27, 2016.