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Pharmacy Directory 2007

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Pharmacy Directory 2007 Pharmacy Directory 2007 Administered by 1 Table of Contents AmeriHealth 65 Basic Pharmacy Directory . .2 Introduction . .2 Frequently Asked Questions . .2 Chain Pharmacies . .6 Retail Pharmacies California . .8 Florida . .39 Kentucky . .70 Pennsylvania . .91 South Carolina . .129 West Virginia . .140 Specialty Network Home Infusion Pharmacies . .147 Indian Health Service / Tribal / Urban Indian Health Program Pharmacies . .161 Long Term Care Pharmacies . .164 Index . .226 2 AmeriHealth 65 Basic Pharmacy Directory This booklet provides a list of AmeriHealth 65 Basic’s network pharmacies. All network pharmacies may not be listed in this directory. Please contact AmeriHealth 65 Basic at 1-888-457-3018, Monday through Sunday, 8:00 AM - 8:00 PM for additional information. Pharmacies may have been added or removed from the list after this directory was printed. To get current information about AmeriHealth 65 Basic network pharmacies in your area, please visit our website at www.amerihealth65.com or call our Member Services Department at 1-888-457-3018, Monday through Sunday, 8:00 AM - 8:00 PM. TTY/TDD users should call 1-888-857-4816. Introduction This booklet provides a list of AmeriHealth 65 Basic’s network pharmacies and includes some basic information about how to fill your prescriptions with AmeriHealth 65 Basic. 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 AmeriHealth 65 Basic. In most cases, your prescriptions are covered under AmeriHealth 65 Basic 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, AmeriHealth 65 Basic may add or remove pharmacies from our pharmacy directory. To get current information about AmeriHealth 65 Basic network pharmacies in your area, please visit our website at www.amerihealth65.com or call our Member Services Department at 1-888-457-3018, Monday through Sunday, 8:00 AM - 8:00 PM. TTY/TDD users should call 1-888-857-4816. How do I find an AmeriHealth 65 Basic network pharmacy in my area? Network pharmacies are first listed in this directory by type of pharmacy (Retail, Long Term Care, Home Infusion and Indian Health Service / Tribal / Urban Indian Health Program (I/T/U)) and are further divided by state, county and zip code. To locate a retail network pharmacy nearest to your home, go to the retail pharmacy section, and then find your state, county and zip code. Note that chain pharmacies are listed at the beginning of the retail section with their toll-free store locator numbers. To locate a Home Infusion, Long Term Care or I/T/U network pharmacy in your area, go to their respective sections, and then find your state. Or, you can visit our website at www.amerihealth65.com or call Member Services at 1-888-457-3018, Monday through Sunday, 8:00 AM - 8:00 PM. TTY/TDD users should call 1-888-857-4816. 3 How do I fill a prescription at a network pharmacy? To fill your prescription at a network pharmacy, you must show your AmeriHealth 65 Basic 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 Member Services. How do I fill a prescription through AmeriHealth 65 Basic’s mail order pharmacy service? To get information about filling your prescriptions by mail, please call our Member Services Department at 1-888-457-3018, Monday through Sunday, 8:00 AM - 8:00 PM. TTY/TDD users should call 1-888-857-4816. In addition to our Member Services Department, you may also call Walgreen’s mail order service at 1-800-489-2197, Monday through Friday, 8:00 AM - 10:00 PM, Saturday and Sunday, 8:00 AM - 5:00 PM. TTY/TDD users should call 1-800-925-0178. Please note that you must use the Walgreen’s mail order service. Prescription drugs that you get through any other mail order service are not covered. You can use the Walgreen’s mail order service to fill prescriptions for any drug that is marked as a mail order drug on the formulary list. When you order prescription drugs by mail, you must order at least a 31-day supply, and no more than a 31-day supply of the drug. You are not required to use mail order prescription drug services to obtain maintenance medications. Instead, you have the option of using a retail pharmacy in our network to obtain a supply of maintenance medications. Please look in the Evidence of Coverage or call our Member Services Department for more information. Please allow up to two weeks for the delivery of any new prescription and seven to ten days for delivery of refill orders. If, for any reason, your mail order is delayed, you may have a prescription filled for a temporary supply of fifteen days at one of our network pharmacies. 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 Member Services 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 below, will help you qualify for catastrophic coverage. To learn how to submit a paper claim, please refer to the paper claims process described next. 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. 4 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. To learn how to submit a paper claim, please refer to the paper claims process described later. You can also call Member Services Department at 1-888-457-3018, Monday through Sunday, 8:00 AM - 8:00 PM to find out if there is a network pharmacy in the area where you are traveling. TTY/TDD users should call 1-888-857-4816. If there are no network pharmacies in that area, Member Services may be able to make arrangements for you to get your prescriptions from an out-of-network pharmacy. We cannot pay for any prescriptions that are filled by pharmacies outside of the United States and territories, even for a medical emergency. What if I need a prescription because of a medical emergency or because I need urgent care? We will cover prescriptions that are filled at an out-of-network pharmacy if the prescriptions are related to care for a medical emergency or urgent care. 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 paper claim form. To learn how to submit a paper claim, please refer to the paper claims process described later. Other times you can get your prescription covered if you go to an out-of-network pharmacy. We will cover your prescription at an out-of-network pharmacy if at least one of the following applies: ● If you are unable to obtain a covered drug in a timely manner within our service area because there is no network pharmacy within a reasonable driving distance that provides 24-hour service. ● If you are trying to fill a prescription drug that is not regularly stocked at an accessible network pharmacy (including high cost and unique drugs).
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