Pharmacy Directory
Total Page：16
File Type：pdf, Size：1020Kb
Pharmacy directory This booklet provides a list of the Blue Medicare Rx network pharmacies. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. To get current information about Blue Medicare Rx network pharmacies in your area, please visit our Web site at: Web site bcbsnc.com/medicare or call our 1-888-247-4142, Customer 7 days a week, Service 8 a.m. – 8 p.m. Department (TTY/TDD at: users should call 1-888-247-4145.) S5540_0377, 8/09/07 Last updated October 2007 U3450a BCBSNC pharmacy r003.indd 1 9/12/07 4:35:45 PM Introduction This booklet provides a list of Blue Cross and Blue Shield of North Carolina (BCBSBC) – Blue Medicare Rx Standard and Enhanced plans network pharmacies and includes some basic information about how to fill your prescriptions with Blue Medicare Rx Standard and Enhanced plans. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage. We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to Plan members. A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by Blue Medicare Rx Standard and Enhanced plans. In most cases, your prescriptions are covered under Blue Medicare Rx Standard and Enhanced plans only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one, you are not required to continue going to the same pharmacy to fill your prescription; you can go to any of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described later. Can the list of network pharmacies change? Yes, Blue Medicare Rx may add or remove pharmacies from our pharmacy directory. To get current information about Blue Medicare Rx network pharmacies in your area, please visit our Web site at www.bcbsnc.com/member/medicare or call our Customer Service Department at 1-888-247-4142, 7 days a week, 8 a.m. to 8 p.m. (TTY/TDD Users should call 1-888-247- 4145.) How do I find a Blue Medicare Rx Standard and Enhanced plans network pharmacy in my area? To find a network pharmacy using this directory, refer to the page tabs beginning on page 7. Use these tabs to find the type of pharmacy you are looking for, including Retail, Chain, Mail-Order Home Infusion, Long-Term Care or Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies. Then choose your county. Pharmacies are listed alphabetically by county. Or, you can visit our Web site at www.bcbsnc.com/member/medicare or call our Customer Service Department at 1-888-247-4142, 7 days a week, 8 a.m. to 8 p.m. (TTY/TDD Users should call 1-888-247-4145.) How do I fill a prescription at a network pharmacy? To fill your prescription at a network pharmacy, you must show your Blue Medicare Rx Member ID card. If you do not have your ID card with you when you fill your prescription, you may have to pay the full cost of the prescription (rather than paying just your co-payment). If this happens, you can ask us to reimburse you for our share of the cost by submitting a claim to us. To find out how to submit a claim, look in your Evidence of Coverage or call our Customer Service Department. 2 Introduction How do I fill a prescription through Blue Medicare Rx Standard and Enhanced plans mail order pharmacy service? To get order forms and information about filling your prescriptions by mail, please visit www.medco.com or call Customer Service at 1-800-442-5781 (TTY/TDD users should call 1-800-716-3231). Please note that you must use the Blue Medicare Rx Standard and Enhanced plans mail order service. Prescription drugs that you get through any other mail order service are not covered. You are not required to use mail order prescription drug services to obtain an extended supply of maintenance medications. Instead, you have the option of using a retail pharmacy in our network to obtain a supply of maintenance medications. Please call our Customer Service Department for more information. It can take 7 to 11 days to receive your medication from the time you order. Make sure you have at least a 14-day supply of that medication on hand. If you do not have enough, ask you doctor to give you a second prescription for a 30-day supply and fill it at a retail network pharmacy while you wait for your mail-order supply to arrive. If your mail-order shipment is delayed, please call Medco at 1-800-442-5781 (TTY/TDD users should call 1-800-716-3231). Medco By Mail is an easy and convenient way to order your long-term prescriptions. BY MAIL 1. Ask your doctor to write a new prescription for up to a 90-day supply of medication, plus refills (as appropriate). 2. Choose a convenient payment method. You may pay by check, money order, or major credit card. If you prefer to pay by credit card, you may also want to join the Medco automatic payment program by simply keeping your credit card information on file with us. 3. Mail the new prescription(s) in a return envelope along with a completed Medco By Mail order form and the appropriate payment. To obtain additional order forms, or if you have questions, please call Medco at 1-800-442-5781. TTY/TDD users should call 1-800-716-3231. BY FAX 1. Ask your doctor to write a new prescription for up to a 90-day supply of medication, plus refills (as appropriate). Give your doctor your Member ID number, which is on your Blue Medicare Rx prescription drug coverage ID card. 2. Ask your doctor to call Medco at 1-888-327-9791 for directions on faxing your prescription to Medco. How to order refills through Medco By Mail To ensure that you don’t run out of your medications, try to reorder at least 2 weeks before your prescription runs out. You can find your refill date on the prescription label and on the refill slip that comes with every order, or visit www.medco.com. You can obtain refills by mailing the order to Medco, calling Medco at 1-800-758-4574. (TTY/TDD users should call 1-800- 716-3231), or by visiting www.medco.com. 3 Filling prescriptions outside the network Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available. Below are some circumstances when we would cover prescriptions filled at an out-of-network pharmacy. Before you fill your prescription in these situations, call Customer Service to see if there is a network pharmacy in your area where you can fill your prescription. If you do go to an out-of-network pharmacy for the reasons listed below, you may have to pay the full cost (rather than paying just your co-payment) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a claim form. However, even after we reimburse you for our share of the cost, you may pay more for a drug purchased at an out-of-network pharmacy because the out-of-network pharmacy’s price is higher than what a network pharmacy would have charged. You should submit a claim to us if you fill a prescription at an out-of-network pharmacy as any amount you pay, consistent with the circumstances listed above, will help you qualify for catastrophic coverage. To learn how to submit a paper claim, please refer to the paper claims process described next. The following are a few exceptions when we will pay for a prescription filled at a pharmacy outside of our network. Getting coverage when you travel or are away from the plan’s service area If you take a prescription drug on a regular basis and you are going on a trip, be sure to check your supply of the drug before you leave. When possible, take along all the medication you will need. You may be able to order your prescription drugs ahead of time through our mail-order pharmacy service. If you are traveling within the United States and territories and become ill, lose or run out of your prescription drugs, we will cover prescriptions that are filled at an out-of-network pharmacy. In this situation, you will have to pay the full cost (rather than paying just your co-payment) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a claim form. If you go to an out-of-network pharmacy, you may be responsible for paying the difference between what we would pay for a prescription filled at an in-network pharmacy and what the out-of-network pharmacy charged for your prescription. To learn how to submit a paper claim, please refer to the paper claims process described later. You can also call Customer Service to find out if there is a network pharmacy in the area where you are traveling. If there are no network pharmacies in that area, Customer Service may be able to make arrangements for you to get your prescriptions from an out-of-network pharmacy.