Pharmacy Directory. Blue Cross Medicare Advantage Dual Care (HMO SNP) SM

Transcription

1 Blue Cross Medicare Advantage Dual Care (HMO SNP) SM Pharmacy Directory For more information, please contact Blue Cross Medicare Advantage Dual Care SM Customer Service, at or, for TTY/TDD users, 711, 8 a.m.- 8 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voic ) will be used on weekends and holidays, or visit mybluesnp.com. This Pharmacy Directory was updated on 09/01/2013. Y0096_BEN_TMP_MAPHAR14 Accepted

2

3 Blue Cross Medicare Advantage Dual Care Pharmacy Directory Introduction This booklet provides a list of Blue Cross Medicare Advantage s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Blue Cross Medicare Advantage s formulary. When this pharmacy directory refers to we, us, or our, it means Blue Cross and Blue Shield of New Mexico. When it refers to plan or our plan, it means Blue Cross Medicare Advantage. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under Blue Cross Medicare Advantage only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage. 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. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of September For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can go to all the pharmacies on this list, but your costs may be less at certain pharmacies in this list, which we have marked with PR. We call these pharmacies preferred pharmacies, and they may offer lower costsharing than other pharmacies. You will still have access to lower drug prices at non-preferred pharmacies than out-of-network pharmacies. You may go to either of these types of pharmacies to receive your covered prescription drugs. This directory is for New Mexico. If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact Blue Cross Medicare Advantage. This information is available for free in other languages. Please call our Customer Service number at (TTY/TDD users should call 711). We are open between 8 a.m. and 8 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voic ) will be used on the weekends and holidays. Esta información está disponible en otros idiomas de forma gratuita. Comuníquese a nuestro número de Servicio al cliente al (los usuarios de TTY/TDD deben llamar al 711). Nuestro horario es de 8 a.m. a 8 p.m., hora local, los 7 días de la semana. Si usted llama del 15 de febrero al 30 de septiembre, durante los fines de semana y feriados, se usarán tecnologías alternas (por ejemplo, correo de voz).

4 KEY R = Retail. We have a nationwide network of pharmacies where you can get covered prescription drugs as a member of our plan. PR = Preferred Retail. Preferred network of pharmacies agreeing to fill 31-day and up to 90-day prescriptions at a preferred rate. EXT = Extended Supply. Extended supply pharmacies offer extended (90-day) supplies. LT = Long-term care pharmacies are pharmacies that service long-term care nursing facilities. Residents of a long-term care facility may access their prescription drugs covered under Blue Cross Medicare Advantage through the facility s long-term care pharmacy or another network long-term care pharmacy. For more information contact customer service at H = Home Infusion. Pharmacies that provide infused (IV) medicine in your home per doctor s order. For more information contact customer service at IN = Indian Health Service/Tribal/Urban Health Program (I/T/U) Pharmacies. Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through Blue Cross Medicare Advantage s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). For more information contact customer service at The key is also listed at the bottom of each Pharmacy Directory page for your reference.

5

6 NEW MEXICO PHARMACY LISTING MAIL ORDER Prim ...(888) (TTY Users 711), 24 hours a day, seven days a week. Or visit BERNALILLO BERNALILLO ALBUQUERQUE ALBUQUERQUE Albuquerque Indian Health Pharmacy...(505) Vassar Dr NE Albuquerque Pharmacy...(505) Louisana Blvd Ste A Albuquerque Pharmacy...(505) Louisiana Blvd NE 87108, LT Best Buy Drugs...(505) Wyoming Blvd NE Caremart Pharmacy...(505) San Pedro Dr SE Ste C Central Pharmacy...(505) Central Ave SE Ste I Coram Specialty Infusion Services...(505) Washington St NE 87109, H Costco Pharmacy...(505) N Renaissance Blvd NE Costco Pharmacy...(505) Eubank Blvd SE Costco Pharmacy...(505) Coors Byp NW CVS Pharmacy...(505) Tramway Blvd NE CVS Pharmacy...(505) Ellison Rd NW CVS Pharmacy...(505) San Mateo Blvd NE CVS Pharmacy...(505) Menaul Blvd NE BERNALILLO CVS Pharmacy...(505) Central Ave SW CVS Pharmacy...(505) Central Ave NE CVS Pharmacy...(505) Montano Rd NW CVS Pharmacy...(505) Tramway Blvd NE CVS Pharmacy...(505) Unser Blvd NW Duran Central Pharmacy...(505) Central Ave NW Highland Pharmacy Inc...(505) Encino Pl NE Ste Hit Specialists...(505) Edith Blvd NE Ste C 87113, H K & M Lab & Pharmacy...(505) Night Whisper Rd NW Ste , LT Kmart Pharmacy...(505) Carlisle Blvd NE Kmart Pharmacy...(505) Central Ave SW Kmart Pharmacy...(505) Montgomery Blvd NE Lovelace Carlisle Pharmacy...(505) Carlisle Blvd NE Lovelace Coors Pharmacy...(505) Coors Blvd NW Lovelace Journal Center Pharmacy...(505) Journal Center Blvd NE Lovelace Juan Tabo Pharmacy...(505) Juan Tabo Blvd NE Lovelace Medical Towers Outpatient Pharmacy...(505) Walter St NE Ste

7 BERNALILLO NEW MEXICO PHARMACY LISTING BERNALILLO BERNALILLO BERNALILLO (cont.) Lovelace Montgomery Pharmacy...(505) Montgomery Blvd NE Lovelace Outpatient Pharmacy...(505) Gibson Blvd SE Lovelace Rio Bravo Pharmacy...(505) Rio Bravo Blvd SE Lovelace Specialty Pharmacy...(505) Walter St NE Ste 202B Lovelace Tramway Pharmacy...(505) Encantado Rd NE Menaul Compounding Pharmacy...(505) Menaul Blvd NE 87112, LT NCS Healthcare of Albuquerque...(505) Washington St NE Ste B , LT, H New Mexico Oncology Hematology Consultants Ltd. (505) Lang Ave NE Pharmaca Integrative Pharmacy...(505) Holly Ave NE Pharmcare Health Services...(505) Academy Pkwy South NE 87109, LT Pharmerica...(505) Broadbent Pkwy NE Ste A Pharmacy Type: LT Phils Pharmacy...(505) Lomas Blvd NE RX Innovations Inc...(505) Washington St NE 87109, LT Sam s Club Pharmacy...(505) Coors Blvd Byp NW Sam s Club Pharmacy...(505) Eubank Blvd NE Sam s Club Pharmacy...(505) N Renaissance Blvd NE Sams Regent Pharmacy...(505) Wyoming Blvd NE Ste 7B Savon Drugs...(505) Eubank Blvd NE Ste A Savon Drugs...(505) Montgomery Blvd NE Savon Drugs...(505) Coors Blvd NW Savon Drugs...(505) Wyoming Blvd NE Savon Drugs...(505) Academy Rd NE Savon Pharmacy...(505) Lomas Blvd NE Savon Pharmacy...(505) Central Ave SW Savon Pharmacy...(505) Rio Bravo Blvd SW Savon Pharmacy...(505) Central Ave SE Savon Pharmacy...(505) Ventura St NE Savon Pharmacy...(505) Juan Tabo Blvd NE Savon Pharmacy...(505) Coors Blvd NW Smith s Pharmacy...(505) Arenal Rd SW Smith s Pharmacy...(505) Lomas Blvd NE Smith s Pharmacy...(505) Golf Course Rd NW Smiths Pharmacy...(505) th St NW Smiths Pharmacy...(505) Tramway Blvd NE Smiths Pharmacy...(505) Tramway Blvd SE

8 BERNALILLO NEW MEXICO PHARMACY LISTING BERNALILLO BERNALILLO BERNALILLO (cont.) Smiths Pharmacy...(505) Academy Rd NE Smiths Pharmacy...(505) Wyoming Blvd NE Ste A Smiths Pharmacy...(505) Coors Blvd NW Smiths Pharmacy...(505) Constitution Ave NE Smiths Pharmacy...(505) Louisiana Blvd NE Smiths Pharmacy...(505) Eubank Blvd NE Smiths Pharmacy...(505) McMahon Blvd NW SW Mesa Center For Family & Community Health Pharmacy...(505) Unser Blvd NW Ste Target Pharmacy...(505) Coors Blvd NW Target Pharmacy...(505) Paseo Del Norte NE Target Pharmacy...(505) Montgomery Blvd NE Target Pharmacy...(505) Lomas Blvd NE Target Pharmacy...(505) Louisiana Blvd NE The Medicine Chest...(505) Candelaria Rd NW University Hosp OP Pharmacy...(505) University Blvd NE Unmh Pharmacy At South East Heights Clinic...(505) Central Ave SE Ste Victor s Regent Pharmacy...(505) Isleta Blvd SW Vida Pharmacy LLC...(505) Jefferson St NE Ste D 87113, LT Walgreens...(505) Menaul Blvd NE Walgreens...(505) Central Ave NW Walgreens...(505) San Pedro Dr NE Walgreens...(505) Montgomery Blvd NE Walgreens...(505) Montgomery Blvd NE Walgreens...(505) th St NW Walgreens...(505) Coors Byp NW Walgreens...(505) Coors Blvd NW Walgreens...(505) Coors Blvd NW Walgreens...(505) Central Ave SE Walgreens...(505) Central Ave SE Walgreens...(505) Lomas Blvd NE Walgreens...(505) Indian School Rd NE Walgreens...(505) Rio Bravo Blvd SW Ste Walgreens...(505) Coors Blvd NW Walgreens...(505) Harper Dr NE Walgreens...(505) Golf Course Rd NW

9 BERNALILLO NEW MEXICO PHARMACY LISTING CIBOLA BERNALILLO BERNALILLO (cont.) Walgreens...(505) Montgomery Blvd NE Walgreens...(505) th St NW Walgreens...(505) Unser Blvd SW Walgreens...(505) Paradise Blvd NW Walgreens...(505) Wyoming Blvd NE Walgreens...(505) Paseo Del Norte NE Walgreens...(505) Eubank Blvd NE Walgreens...(505) Central Ave NE Walgreens...(505) Unser Blvd NW Walgreens...(505) Menaul Blvd NE Walgreens...(505) Unser Blvd NW Walgreens...(505) Ventura St NE Walgreens...(505) Gibson Blvd SW Walgreens Infusion Services...(505) Alexander Blvd NE Ste A Pharmacy Type: H Walmart Pharmacy...(505) Academy Rd NE Walmart Pharmacy...(505) San Mateo Blvd SE Walmart Pharmacy...(505) Eubank Blvd NE Walmart Pharmacy...(505) Carlisle Blvd NE Walmart Pharmacy...(505) Coors Byp NW Walmart Pharmacy...(505) Coors Blvd NW Walmart Pharmacy...(505) Coors Blvd SW Walmart Pharmacy...(505) Golf Course Rd NW Walmart Pharmacy...(505) Sage Rd SW Walmart Pharmacy...(505) Wyoming Blvd NE Walmart Pharmacy...(505) Menaul Blvd NE ISLETA ISLETA Isteta Health Center Pharmacy...(505) Sagebrush St LOS RANCHOS LOS RANCHOS Pharmacy Plus...(505) Osuna Rd NW Walgreens...(505) th St NW CIBOLA CIBOLA GRANTS GRANTS Parkhurst Pharmacy...(505) Bonita St Trust Pharmacy...(505) E Roosevelt Ave Walmart Pharmacy...(505) Roberts Dr

10 CIBOLA NEW MEXICO PHARMACY LISTING SAN MIGUEL CIBOLA CIBOLA (cont.) Western NM Medical Group Grants...(505) Bonita St PINE HILL PINE HILL Pine Hill Health Center...(505) BIA Rt SAN FIDEL SAN FIDEL ACL Pharmacy...(505) Exit 203 Acomita GUADALUPE GUADALUPE SANTA ROSA SANTA ROSA Route 66 Pharmacy...(575) Camino De Vida Ste , LT, H LOS ALAMOS LOS ALAMOS LOS ALAMOS LOS ALAMOS Los Alamos Medical Center Outpatient Pharmacy...(505) West Rd Smiths Pharmacy...(505) Central Ave WHITE ROCK WHITE ROCK Smiths Pharmacy...(505) Sherwood Blvd RIO ARRIBA CHAMA CHAMA RIO ARRIBA Rio Drugs of Chama...(575) S Terrace Ave DULCE DULCE Dulce IHS Pharmacy...(505) Stone Lake Rd EL RITO EL RITO Las Clinicas Del Norte...(575) Hwy , LT ESPANOLA ESPANOLA CVS Pharmacy...(505) N Riverside Dr Santa Clara IHS Pharmacy...(505) Rte Valley Community Health Center...(505) N Riverside Dr Walgreens...(505) N Riverside Dr Walmart Pharmacy...(505) N Riverside Dr SAN MIGUEL SAN MIGUEL LAS VEGAS LAS VEGAS Del Norte Pharmacy & Home Medical of La Vegas...(505) University Ave 87701, LT New Mexico Behavioral Health Institue At Las Vegas (505) Hot Springs Blvd 87701, LT Plaza Drugs...(505) Bridge St Walgreens...(505) Mills Ave Walmart Pharmacy...(505) th St

11 SANDOVAL NEW MEXICO PHARMACY LISTING SANDOVAL SANDOVAL BERNALILLO BERNALILLO SANDOVAL Pharmacy Plus...(505) W Hwy Santa Ana Health Clinic Pharmacy...(505) Dove Rd Ste C Walgreens...(505) E Hwy Walmart Pharmacy...(505) Hwy CANON CANON Jemez Valley Medical Clinic...(575) State Hwy COCHITI PUEBLO COCHITI PUEBLO Cochiti IHS Pharmacy...(505) Cochiti St COUNSELOR COUNSELOR Counselor Navajo Clinic...(575) US Hwy CUBA CUBA Cuba Health Center...(575) US Hwy Cuba Health Center Pharmacy...(575) US Hwy Cuba School Based Health Center...(575) Ste 50 County Rd JEMEZ PUEBLO JEMEZ PUEBLO Jemez Health Center Pharmacy...(575) Sheep Springs Rd OJO ENCINO OJO ENCINO Ojo Encino Navajo Clinic...(505) Ste 2 Ojo Encino Chapter House Rd RIO RANCHO RIO RANCHO CVS Pharmacy...(505) NM 528 SE Kmart Pharmacy...(505) Rio Rancho Dr SE Lovelace Rio Rancho Pharmacy...(505) Rio Rancho Dr SE Presbyterian Intel Health For Life Center...(505) Sara Rd SE Ste MSRR Rio Rancho Family Health Ctr...(505) Unser Blvd NE Savon Drugs...(505) Ridgecrest Dr SE Savon Pharmacy...(505) Southern Blvd SE Savon Pharmacy...(505) Enchanted Hills Blvd NE Smiths Pharmacy...(505) Rio Rancho Dr SE Walgreens...(505) Southern Blvd SE Walgreens...(505) Southern Blvd SE Walgreens...(505) Enchanted Hills Blvd NE Walgreens...(505) Northern Blvd NE

12 SANDOVAL NEW MEXICO PHARMACY LISTING SANTA FE SANDOVAL SANDOVAL (cont.) Walmart Pharmacy...(505) Unser Blvd SE SAN FELIPE SAN FELIPE San Felipe Health Clinic Pharmacy...(505) Cedar St 4 San Felipe Pueblo SAN YSIDRO SAN YSIDRO Zia Indian Health Clinic Pharmacy...(505) B Capitol Square Dr SANTA DOMINGO SANTA DOMINGO Santa Domingo Pharmacy...(505) San Ildefonso St SANTO DOMINGO SANTO DOMINGO Santo Domingo Pueblo Health Center...(505) West Hwy TORREON TORREON Torreon Navajo Clinic...(505) State Hwy SANTA FE SANTA FE CERRILLOS CERRILLOS Ortiz Mountain Health Center...(505) B Main St EDGEWOOD EDGEWOOD Smiths Pharmacy...(505) B State Rd Walgreens...(505) Walker Rd Walmart Pharmacy...(505) State Rd ESPANOLA ESPANOLA Fairview Pharmacy...(505) N Riverside Dr Ste A SANTA FE SANTA FE CVS Pharmacy...(505) W Cordova Rd CVS Pharmacy...(505) Paseo De Peralta Del Norte Pharmacy & Home Medical of Santa Fe...(505) Galisteo St Kmart Pharmacy...(505) St Michael S Dr Lovelace St Michaels Pharmacy...(505) Saint Michaels Dr Ste Medicap...(505) Avenida Vista Grande Ste B8 The Agora Medicap Pharmacy...(505) Rodeo Rd Ste A Nambe Drugs...(505) Cities of Gold Rd Pharmaca Integrative Pharmacy...(505) W Cordova Rd Ste B Sam s Club Pharmacy...(505) Rodeo Rd Santa Fe Community Guidance Center...(505) Rodeo Park Dr W Santa Fe Indian Hospital Pharmacy...(505) Cerrillos Rd Savon Pharmacy...(505) S Saint Francis Dr Savon Pharmacy...(505) Zafarano Dr

13 SANTA FE NEW MEXICO PHARMACY LISTING VALENCIA SANTA FE SANTA FE (cont.) Savon Pharmacy...(505) N Guadalupe St Smiths Pharmacy...(505) Cerrillos Rd Smiths Pharmacy...(505) S Pacheco St Southwest Care Center...(505) Harkle Rd Ste C Teen Health Center - Capital High School...(505) Paseo Del Sol Teen Health Center -Santa Fe High School...(505) Yucca St Walgreens...(505) S Saint Francis Dr Walgreens...(505) Cerrillos Rd Walgreens...(505) W Zia Rd Walgreens...(505) Airport Rd Walmart Pharmacy...(505) Cerrillos Rd Walmart Pharmacy...(505) Herrera Dr Wiley Chemists Inc...(505) Hospital Dr SOCORRO SOCORRO MAGDALENA MAGDALENA Alamo Navajo Health Center...(575) Hwy 169 Mile Marker Magdalena Clinic...(575) th St SOCORRO SOCORRO Smiths Pharmacy...(575) N California St Socorro Community Health Ctr...(575) Enterprise Walmart Pharmacy...(575) th St N TORRANCE TORRANCE ESTANCIA ESTANCIA Esperanza Family Health Center...(505) N 5th St Ste C MORIARTY MORIARTY May Health Mrt Pharmacy II...(505) Central MOUNTAINAIR MOUNTAINAIR Mountainair Family Health Center...(505) East Pinon Mountainair Meds & More LLC...(505) W Broadway VALENCIA VALENCIA BELEN BELEN Buckland Pharmacy...(505) Dalies Ave Share N Care Pharmacy...(505) Dalies Ave Ste B 87002, LT, H Share N Care Pharmacy & Medical Supply...(505) Dalies Ave Walgreens...(505) N Main St

14 VALENCIA NEW MEXICO PHARMACY LISTING VALENCIA VALENCIA VALENCIA (cont.) Walmart Pharmacy...(505) I-25 Byp LOS LUNAS LOS LUNAS Savon Pharmacy...(505) Main St SE Smiths Pharmacy...(505) Hwy 47 & Walgreens...(505) Main St NE Walgreens...(505) Main St NW Walmart Pharmacy...(505) Main St NW PERALTA PERALTA Joes Pharmacy...(505) State Hwy

15 10

16 For more information, please contact Blue Cross Medicare Advantage Customer Service, at or, for TTY/TDD users, 711, 8 a.m.-8 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voic ) will be used on weekends and holidays, or visit mybluesnp.com. This Pharmacy Directory was updated on 09/01/2013. Prim is offered by Prime Therapeutics. Prime Therapeutics is a separate company from Blue Cross and Blue Shield of New Mexico and provides pharmacy benefit management services for Blue Cross Medicare Advantage. HMO, HMO-POS, PPO, and HMO Special Needs Plans provided by Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the Blue Cross and Blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract and a contract with the New Mexico Medicaid program. Enrollment in HCSC s plans depends on contract renewal.