DIRECTORY. UnitedHealthcare MedicareRx for Groups (PDP)

Transcription

1 2015 Pharmacy DIRECTORY UnitedHealthcare MedicareRx for Groups (PDP) This directory is a partial list of network pharmacies near you. This directory is for Maine. For more information, please call Customer Service at: Toll-Free , TTY a.m. to 8 p.m. local time, Monday through Friday Y0066_140805_ Last updated October 2014

2 About this PHARMACY DIRECTORY This directory is a partial list of the plan s network pharmacies. It lists pharmacies in your area based on your State. Pharmacies are listed in alphabetical order. 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 may no longer be in our network, or there may be newer pharmacies in our network that are not listed. It is current as of the date printed on the front and back cover pages of this directory. For the most current list of our network pharmacies, please see the front and back cover pages of this directory for information on how to contact us. Network pharmacies A network pharmacy is a pharmacy where you get prescription drug benefits provided by your plan. We call the pharmacies in this directory our network pharmacies because we have made arrangements with them to provide prescription drugs to our plan members. In most cases, your prescriptions are covered under the plan only if they are filled at one of our network pharmacies or through a mail order service pharmacy. We have a large service area with many pharmacies where you may fill your prescription drugs. This directory lists network pharmacies in your area. For information about additional network pharmacies, please contact us using the information on the front and back cover pages. You do not have to use the same network pharmacy every time you fill a prescription drug. You may use any of our network pharmacies. In certain situations we may cover prescriptions filled at pharmacies outside of the network. Please see your Evidence of Coverage for more information. For a complete description of your prescription drug coverage, including how to fill your prescriptions, please see your Evidence of Coverage and Drug List (Formulary). If you have questions about any of the above, please see the front and back cover pages of this directory for information on how to contact us. Pharmacy Saver Pharmacy Saver is a cost savings prescription drug program available to our plan members. The plan has worked with many of our network pharmacies to offer even lower prices on many common prescription drugs. 1 To learn more about Pharmacy Saver or to see the full list of participating pharmacies, visit Pharmacies included in the Pharmacy Saver program are indicated by a listings on the following pages. symbol in the pharmacy

3 Mail order service pharmacy A network mail service pharmacy is where members can get their prescription drugs delivered to their mailbox. You may go to any of the plan s network mail service pharmacies to get your covered prescription drugs. You can use one of the plan s mail service pharmacies in our network, OptumRx Mail Service Pharmacy. Members can get a 90-day supply 2 of some of their prescription drugs. Members may also use other mail service pharmacies to fill prescriptions. You are not required to use OptumRx to obtain a 90-day supply of your maintenance medications, but you may pay more out-of-pocket compared to using OptumRx, your plan s Mail Service Pharmacy. Prescription orders sent directly to OptumRx from your doctor must have your approval before OptumRx can send your medications. This includes new prescriptions and prescription refills. OptumRx will contact you, by phone, to get your approval. At that time you may also tell OptumRx to fill any future prescriptions they receive directly from your doctor(s) for up to one year. If OptumRx is unable to reach you for approval your prescription will not be sent to you. Refunds may be available for prescriptions you did not approve and did not want. You may request a refund or cancel your approval by calling OptumRx at , TTY 711, 24 hours, 7 days a week. New prescriptions should arrive within ten business days from the date the completed order is received by the Mail Service Pharmacy. Completed refill orders should arrive in about seven business days. OptumRx will contact you if there will be an extended delay in the delivery of your medications. You can find more information about Mail Service Pharmacy by calling OptumRx at the number listed in the Mail service pharmacies section of this directory. Mail service pharmacies are indicated by a symbol in the pharmacy listings on the following pages.

4 90-day supplies from retail pharmacies You do not have to use a mail service pharmacy to get a 90-day supply of your prescription drugs. Some of the retail pharmacies in the plan s network also offer 90-day supplies of prescription drugs. If you fill a 90-day supply at a retail pharmacy, you may pay more. Retail pharmacies in the network that fill 90-day supplies of prescription drugs are indicated by a symbol in the pharmacy listings on the following pages. E-prescribing Some of our network pharmacies use electronic prescribing, or e-prescribing. The pharmacy receives your prescriptions electronically, directly from your doctor. Your prescription may be sent before you even leave your doctor s office. E-prescribing can be a safe and efficient way for network pharmacies to get your prescriptions. It may help the pharmacy avoid reading mistakes and may alert your doctor to drugs that should not be taken together. Network pharmacies that use e-prescribing are indicated by an the following pages. symbol in the pharmacy listings on

5 National pharmacy chains Below are some of the national chains in the plan s pharmacy network. For locations and phone numbers of stores in your area, call the numbers shown below. Duane Reade Food Lion Giant Giant Food Stores Hannaford H-E-B Hy-Vee Kroger & Affiliates Baker s Pharmacy City Market Dillons Fred Meyer Fry s Pharmacy Gerbes JayCs King Soopers Kroger Pay Less Pharmacy QFC Pharmacy Ralphs Scotts Smith s Food & Drug Martins Publix Safeway & Affiliates Carrs Quality Center Pavilion's Randalls Safeway Tom Thumb Vons Sam s Club Stop & Shop Target Pharmacy Thrifty White Walgreens TTY Walmart Wegmans TTY users should call 711, unless a different phone number is listed. This list may change. For a current list of national pharmacy chains or to check for a pharmacy not listed in this directory, call us at the number located on the front and back cover pages of this directory.

6 Below are some of the retail and chain pharmacies in your area. Note: Pharmacies may have closed or moved locations since this directory was printed. Other pharmacies are available in our network. Androscoggin Bedard Pharmacy 61 College St Lewiston, ME , TTY: 711 Cmmc Pharmacy 12 High Street 300 Main Street (Mailing) Lewiston, ME , TTY: 711 Bedard Pharmacy Incorporated 359 Minot Avenue Auburn, ME , TTY: 711 Greene Village Pharmacy 19B Patten Road Greene, ME , TTY: 711 Bedard Senior Care Inc 359 Minot Ave Ste C Auburn, ME , TTY: Sabattus Street Lewiston, ME , TTY: Sabattus St Lewiston, ME , TTY: Spring St Auburn, ME , TTY: Union St Auburn, ME , TTY: 711 Hannaford Supermarket & Pharmacy 23 Snell Hill Rd Turner, ME , TTY: East Avenue Lewiston Sc Lewiston, ME , TTY: 711 Kmart Pharmacy 603 Center Street Auburn, ME , TTY: 711

7 Medicine Shoppe Pharmacy 373 Sabattus St Lewiston, ME , TTY: Minot Avenue Auburn, ME , TTY: 711 Osco Pharmacy 600 Center St Auburn, ME , TTY: Lisbon Street Lewiston, ME , TTY: 711 Osco Pharmacy 27 East Ave Lewiston, ME , TTY: Lisbon Street Lisbon Falls, ME , TTY: Main Street Livermore Falls, ME , TTY: Mt Auburn Ave Auburn, ME , TTY: Union Street Auburn, ME , TTY: Main Street Lewiston, ME , TTY: 711 Aroostook City Drug Store 172 Academy St Presque Isle, ME , TTY: 711 Frontier Pharmacy 153 Bennett Dr Caribou, ME , TTY: Sabattus Street Lewiston, ME , TTY: 711

8 Hebert Rexall Pharmacy 74 Main St Van Buren, ME , TTY: 711 Presque Isle Pharmacy 797 Main St Presque Isle, ME , TTY: 711 I Care Pharmacy 227 Main St Fort Fairfield, ME , TTY: East Main Street Fort Kent, ME , TTY: 711 Madawaska Pharmacy LLC 104 Main St Madawaska, ME , TTY: Main Street Van Buren, ME , TTY: 711 Mars Hill Pharmacy Inc 106 Main St Mars Hill, ME , TTY: North Street Houlton, ME , TTY: 711 Paradis Shop N Save 114 High St Pb Box 230 Caribou, ME , TTY: Bennett Drive Caribou, ME , TTY: 711 Paradis Shop N Save 33 Ludlow Rd Houlton, ME , TTY: Main Street Madawaska, ME , TTY: 711 Paradis Shop N Save 62 West Main St Suite 101 Fort Kent, ME , TTY: Main Street Fort Fairfield, ME , TTY: 711

9 320 Main Street Presque Isle, ME , TTY: 711 Shiretown Pharmacy 101 Military Street Houlton, ME , TTY: 711 St John Valley LTC 182 Market St Ste 3 Ft Kent, ME , TTY: 711 St John Valley Pharmacy 182 Market St Ste 2 Fort Kent, ME , TTY: Main Street Presque Isle, ME , TTY: Ludlow Road Houlton, ME , TTY: 711 Cumberland Apothecary By Design Specialty A 141 Preble St Portland, ME , TTY: 711 Briovarx of Maine, Inc. 53 Darling Ave S Portland, ME , TTY: Congress Street West Gate S Portland, ME , TTY: Ocean House Road Cape Elizabeth, ME , TTY: Market St So Portland, ME , TTY: Auburn St Portland, ME , TTY: 711

10 449 Forest Avenue Portland, ME , TTY: Brighton Avenue Pine Tree Shopping Ctr Portland, ME , TTY: Roosevelt Trail Route 302 Shaws Plaza Windham, ME , TTY: 711 Community Pharmacy-Gorham 365 Main St Gorham, ME , TTY: Middle St Freeport, ME , TTY: Ossipee Trail Colonial Marke Standish, ME , TTY: Bath Rd Route 24 Merrymeeting Plaza Brunswick, ME , TTY: Main Street Westbrook, ME , TTY: Congress Street Portland, ME , TTY: Gray Road Falmouth, ME , TTY: Cottage Rd So Portland, ME , TTY: Philbrook Avenue So Portland, ME , TTY: 711

11 295 Forest Ave Portland, ME , TTY: Roosevelt Trail Windham Mall No Windham, ME , TTY: Hannaford Drive Scarborough, ME , TTY: Elm St Brunswick, ME , TTY: Main St Gorham, ME , TTY: 711 Hannaford Supermarket & Pharmacy 130 Shaker Rd Gray, ME , TTY: Route 1 Shoppers Village Yarmouth, ME , TTY: Riverside St Portland, ME , TTY: Portland Road Bridgton, ME , TTY: Hannaford Drive Westbrook, ME , TTY: 711 Kennebec Pharmacy & Home Care 121 Medical Center Dr Ste G500 Brunswick, ME , TTY: 711 Moby Rx 225 Waterman Dr South Portland, ME , TTY: 711 New England Life Care 108 A Industrial Way Portland, ME , TTY: 711 Omnicare of Maine 39 Eisenhower Dr Westbrook, ME , TTY: 711

12 Osco Pharmacy 200 Lower Main St Freeport, ME , TTY: Congress Street West Portland, ME , TTY: 711 Osco Pharmacy 417 Payne Rd Scarborough, ME , TTY: Depot Rd Falmouth, ME , TTY: 711 Osco Pharmacy 91 Auburn St Northgate Shopping Portland, ME , TTY: Congress Street Portland, ME , TTY: 711 Osco Pharmacy 147 Bath Rd Brunswick, ME , TTY: Route 1 Yarmouth, ME , TTY: 711 Osco Pharmacy 31 Main St Westbrook, ME , TTY: Main Street South Portland, ME , TTY: 711 Pharmerica 97 Mcalister Farm Road Portland, ME , TTY: Roosevelt Trail Naples, ME , TTY: 711 Portland Pharmacy I 331 Veranda St Portland, ME , TTY: West Gray Road Gray, ME , TTY: 711

13 465 Main Street Westbrook, ME , TTY: 711 Sams Pharmacy 440 Payne Road Scarbourough, ME , TTY: Allen Avenue Portland, ME , TTY: 711 Target Pharmacy 200 Running Hill Road South Portland, ME , TTY: Maine Street Brunswick, ME , TTY: Gallery Blvd Scarborough, ME , TTY: Portland Road Bridgton, ME , TTY: Tibbetts Drive Brunswick, ME , TTY: Forest Avenue Portland, ME , TTY: Landing Road Windham, ME , TTY: Main Street Gorham, ME , TTY: US Route 1 Falmouth, ME , TTY: US Route One Scarborough, ME , TTY: 711 Walgreens 127 Marginal Way Portland, ME , TTY: 711

14 Walgreens 741 Roosevelt Trl Windham, ME , TTY: 711 Mt. Blue Drug 624 Wilton Road Farmington, ME , TTY: 711 Walgreens 233 US Route 1 Scarborough, ME , TTY: Main Street Farmington, ME , TTY: 711 Walgreens 340 Allen Ave Portland, ME , TTY: 711 Spruce Mountain Pharmacy Inc. 3 Tweedie Street Jay, ME , TTY: 711 Walgreens 616 Forest Ave Portland, ME , TTY: Wilton Road Farmington, ME , TTY: 711 Waltz Long Term Care Pharmacy 3 Business Pkwy Ste 2 Brunswick, ME , TTY: 711 Franklin 15 Jay Plaza Pane Jay, ME , TTY: Shop N Save Drive Suite 1 Farmington, ME , TTY: 711 Western Maine Pharmacy, Inc. 238 Main St Kingfield, ME , TTY: 711 Hancock Carroll Drug Store 3 Village Green Way PO Box 1306 Southwest Harbor, ME , TTY: 711

15 Community Pharmacy-Blue Hill 15 South St Blue Hill, ME , TTY: South Street Blue Hill, ME , TTY: 711 Community Pharmacy-Bucksport 75 Main St Bucksport, ME , TTY: High Street Suite 1 Ellsworth, ME , TTY: 711 Hannaford Supermarket & Pharmacy 86 Cottage St Bar Harbor, ME , TTY: 711 Osco Pharmacy 175 High St Ellsworth, ME , TTY: High Street Ellsworth, ME , TTY: US Oute 1 Suite 1 Bucksport, ME , TTY: 711 V & S Pharmacy 3 Burnt Cove Rd Stonington, ME , TTY: Myrick St Ellsworth, ME , TTY: 711 Walgreens 226 High St Ellsworth, ME , TTY: 711 West End Drug Company 105 Main St Bar Harbor, ME , TTY: Cottage Street Bar Harbor, ME , TTY: 711

16 Kennebec 2 Stone St Augusta, ME , TTY: Capitol St Augusta, ME , TTY: Kennedy Memorial Drive Waterville, ME , TTY: 711 Central Maine Pharmacy 18 China Road Albion, ME , TTY: 711 Community Pharmacy-Randolph 268 Water St Randolph, ME , TTY: 711 Dirigo Drug LLC 1144 Main St Clinton, ME , TTY: 711 Gardiner Apothecary, LLC 35 Bridge St Gardiner, ME , TTY: JFK Plaza Kennedy Memorial D Waterville, ME , TTY: Main Street Gardiner, ME , TTY: Whitten Road Augusta, ME , TTY: Elm Plaza Waterville, ME , TTY: 711 Hannaford Supermarket & Pharmacy 118 Cony St Augusta, ME , TTY: 711 Hannaford Supermarket & Pharmacy 399 Main St Winthrop, ME , TTY: 711

17 Hannaford Supermarket & Pharmacy 33 Hannaford Drive China, ME , TTY: North Belfast Avenue Augusta, ME , TTY: 711 Kennebec Pharmacy and Home Care 43 Leighton Rd Augusta, ME , TTY: Western Avenue Manchester, ME , TTY: 711 Mvh Pharmacy 5 Community Dr Ste 3 Augusta, ME , TTY: Hospital Street Augusta, ME , TTY: 711 Mvh Pharmacy (External Non Va Bu 5 Community Dr Ste 1 Augusta, ME , TTY: China Road Winslow, ME , TTY: 711 Oakland Pharmacy 54 Main Street Oakland, ME , TTY: Peck Farm Road Winthrop, ME , TTY: 711 Osco Pharmacy 150 Western Ave Augusta, ME , TTY: Main Street Oakland, ME , TTY: 711 Osco Pharmacy 251 Kennedy Memorial Dr Waterville, ME , TTY: Spring Street Gardiner, ME , TTY: 711

18 210 Main Street Waterville, ME , TTY: 711 Target Pharmacy 119 Crossing Way Augusta, ME , TTY: Civic Center Dr Augusta, ME , TTY: Waterville Commons Drive Waterville, ME , TTY: 711 Walgreens 45 Grove St Augusta, ME , TTY: 711 Winslow Pharmacy 20 Garland Rd Winslow, ME , TTY: 711 Knox 75 Maverick St Rockland, ME , TTY: 711 Hannaford Supermarket & Pharmacy 145 Elm St Camden, ME , TTY: 711 Jensen's Pharmacy 91 Camden St Ste 105 Rockland, ME , TTY: 711 Kennebec Phcy and Home Care 839 Commercial St Rockport, ME , TTY: 711 Osco Pharmacy 235 Camden St Rockland, ME , TTY: 711 Penobscot Bay Med Center Phcy 6 Glen Cove Dr Rockport, ME , TTY: 711

19 35 Elm Street Camden, ME , TTY: Townsend Avenue Boothbay Harbor, ME , TTY: Park Street Rockland, ME , TTY: Thomaston Commons Way Thomaston, ME , TTY: 711 Lincoln Community Pharmacy-Waldoboro 5 Friendship St Waldoboro, ME , TTY: 711 Oxford 1603 Main Street Oxford, ME , TTY: Waldo Street Rumford, ME , TTY: Main Street South Paris, ME , TTY: Main Street Damariscotta, ME , TTY: Portland Street Rumford, ME , TTY: Main Street Damariscotta, ME , TTY: Bridgton Road Fryeburg, ME , TTY: 711

20 28 Mayville Road Bethel, ME , TTY: 711 Community Pharmacy-Dexter 37 Church St Dexter, ME , TTY: Main St/Rt 26 Oxford, ME , TTY: 711 Community Pharmacy-Newport 44 Moosehead Trail Newport, ME , TTY: River Road Mexico, ME , TTY: 711 Davis Pharmacy 59 Main St E Millinocket, ME , TTY: 711 Walgreens 53 Paris St Norway, ME , TTY: Broadway , TTY: 711 Penobscot Brewer Medical Center Pharmacy 735 Wilson St Brewer, ME , TTY: 711 Community Pharmacy-Corinth 689 Main St Corinth, ME , TTY: Goding Avenue Lincoln, ME , TTY: Wilson St Brewer, ME , TTY: Stillwater Ave Old Town, ME , TTY: 711

21 1133 Union St , TTY: 711 Miller Drug Westgate 915 Union St Ste , TTY: Central St Millinocket, ME , TTY: 711 Miller Drug Whiting Hill 33 Whiting Hill Rd Ste 4 Brewer, ME , TTY: 711 Hannaford Supermarket & Pharmacy 77 Western Ave Hampden, ME , TTY: 711 Orono Pharmacy 16 Mill St Orono, ME , TTY: 711 Helen Hunt Health Center Pharmac 242 Brunswick St Old Town, ME , TTY: 711 Osco Pharmacy 353 Main St , TTY: 711 Miller Drug LTC 208 State St , TTY: 711 Patten Drug Company 20 Main St Patten, ME , TTY: 711 Miller Drug Riverside 417 State St Ste , TTY: 711 Penobscot Community Health Cente 1012 Union St Ste , TTY: 711 Miller Drug State Street 210 State St , TTY: 711

22 Penobscot Nation Hlth Departmnt 23 Wabanaki Way Indian Island, ME , TTY: Central Street Millinocket, ME , TTY: Wilson Street Brewer, ME , TTY: Union Street , TTY: Main Street Old Town, ME , TTY: Western Avenue Hampden, ME , TTY: Broadway , TTY: West Broadway Lincoln, ME , TTY: Spring Street Dexter, ME , TTY: 711 Sams Pharmacy 47 Haskell Road , TTY: Union Street , TTY: 711 Target Pharmacy 60 Longview Dr , TTY: Moosehead Trail Newport, ME , TTY: Stillwater Ave , TTY: 711

23 250 West Broadway Lincoln, ME , TTY: Walton Drive Brewer, ME , TTY: 711 Walgreens 437 Wilson St Brewer, ME , TTY: 711 Walgreens 706 Broadway , TTY: 711 Walgreens 97 Oak St , TTY: 711 Piscataquis Harris Drug 10 Pritham Ave Greenville, ME , TTY: 711 Osco Pharmacy 1073 W Main St Suite 9 Dover Foxcroft, ME , TTY: East Main Street Dover-Foxcroft, ME , TTY: Hudson Avenue Guilford, ME , TTY: Park Street Milo, ME , TTY: 711 Sagadahoc 1 Chandler Dr Suite 27 Bath, ME , TTY: Topsham Fair Mall Road Suite Topsham, ME , TTY: 711

24 77 Mallett Drive Topsham, ME , TTY: Fairground Market Place Skowhegan, ME , TTY: 711 Target Pharmacy 125 Topsham Fair Mall Rd Topsham, ME , TTY: Somerset Avenue Pittsfield, ME , TTY: 711 Walgreens 11 State Rd Bath, ME , TTY: Madison Avenue Skowhegan, ME , TTY: 711 Wilsons Drug Store 114 Front St Bath, ME , TTY: Main Street Fairfield, ME , TTY: 711 Somerset Community Pharmacy-Pittsfield 101 Somerset Plz Pittsfield, ME , TTY: 711 E W Moore and Son Pharmacy 337 Main St Bingham, ME , TTY: 711 Fairfield Pharmacy 66 Western Ave Fairfield, ME , TTY: 711 Taylor's Drug Store 2 Old Point Ave Madison, ME , TTY: 711 Variety Drug 78 Water St Skowhegan, ME , TTY: Main Street Palmyra, ME , TTY: 711

25 60 Fairgrounds Market Place Skowhegan, ME , TTY: 711 Hannaford Supermarket & Pharmacy 149 Dublin St Machias, ME , TTY: 711 Waldo 93 Lincolnville Avenue Belfast, ME , TTY: Main Street Belfast, ME , TTY: 711 Unity Pharmacy 33 Plaza Dr Unity, ME , TTY: 711 Walgreens 268 Main St Belfast, ME , TTY: 711 Washington Eastport Family Pharmacy 60 Water St Eastport, ME , TTY: 711 Machias Friendly Pharmacy 8 Old Country Rd Marshfield, ME , TTY: 711 Milbridge Pharmacy 11 Main Street Milbridge, ME , TTY: 711 Passamaquoddy Health Center 401 Peter Dana Point Rd. Princeton, ME , TTY: Dublin Street Machias, ME , TTY: North Street Calais, ME , TTY: 711 Treworgy Pharmacy 333 Main St Calais, ME , TTY: 711

26 379 South St Calais, ME , TTY: 711 York 11 Steeple Way Wells, ME , TTY: 711 Community Pharmacy-Cornish 200 Maple St Unit 3 Cornish, ME , TTY: 711 Community Pharmacy-Saco 244 Main St Saco, ME , TTY: Main St Ste D Sanford, ME , TTY: Portland Rd Kennebunk, ME , TTY: Elm St Biddeford, ME , TTY: 711 Colonial Pharmacy 40 Dock Square Kennebunkport, ME , TTY: 711 Good For All Pharmacy 10 Goodall Dr Ste 800 East Waterboro, ME , TTY: Main Street Sanford, ME , TTY: Wells Plaza US Route 1 Wells, ME , TTY: Main St Saco, ME , TTY: 711

27 20 Sokokis Trail East Waterboro, ME , TTY: US Route 1 York, ME , TTY: Elm Street Biddeford, ME , TTY: 711 Hannaford Supermarket & Pharmacy 24 Portland Rd Buxton, ME , TTY: 711 Hannaford Supermarket & Pharmacy 65 Portland Rd Kennebunk, ME , TTY: 711 Kennebunk Village Pharmacy Inc 18 Blue Wave Professional Center Kennebunk, ME , TTY: 711 Osco Pharmacy 4 Scammon St Suite 12 Saco, ME , TTY: 711 Osco Pharmacy 1364 Main St Sanford, ME , TTY: Portland Road Kennebunk, ME , TTY: Alfred Street Biddeford, ME , TTY: US Rt 1 York, ME , TTY: Main Street Springvale, ME , TTY: 711 Osco Pharmacy 510 Alfred Rd Biddeford, ME , TTY: 711

28 15 Shapeleigh Road Kittery, ME , TTY: 711 Target Pharmacy 585 Alfred Road Route 111 Biddeford, ME , TTY: Saco Avenue Old Orchard Beach, ME , TTY: Main Street Sanford, ME , TTY: Maple Street Cornish, ME , TTY: Alfred Street Biddeford, ME , TTY: Main Street Saco, ME , TTY: 711 Walgreens 868 Main St Sanford, ME , TTY: Parker Farm Road Buxton, ME , TTY: 711 York Hosp Berwick Phcy 4 Dana Dr Berwick, ME , TTY: Post Road Wells, ME , TTY: 711 York Hospital Apothecary 15 Hospital Dr York, ME , TTY: 711 South Berwick Pharmacy Seacoast 289 Main St South Berwick, ME , TTY: 711

29 Mail service pharmacies Our mail service pharmacies will ship your prescription drugs directly to your home. For more information, please see your Evidence of Coverage. Below are the mail service pharmacies in the plan s network. OptumRx Walgreens Mail Service P.O. Box 2975 P.O. Box , Orlando, FL Mission, KS P.O. Box 29061, Phoenix, AZ , TTY , TTY Home infusion pharmacies near you The plan will cover home infusion therapy if: The plan has approved your prescription drug for home infusion therapy; and You get your prescription from an authorized prescriber. For more information, please see your Evidence of Coverage. Below are some of the home infusion network pharmacies in your area. Androscoggin New England Home Therapies 49 Omni Cir Auburn, ME , TTY: 711 Cumberland Coram CVS/Specialty Infusion Ser 12 Northbrook Drive, Building B, Falmouth, ME , TTY: 711 New England Life Care 108 A Industrial Way Portland, ME , TTY: 711 Kennebec Kennebec Pharmacy and Home Care 43 Leighton Rd Augusta, ME , TTY: 711 Long-term care pharmacies near you Residents of a long-term care facility may get their covered prescription drugs from their facility s long-term care pharmacy or another network long-term care pharmacy. For more information, please see your Evidence of Coverage. Below are some of the long-term care network pharmacies in your area.

30 Long-term care pharmacies near you Androscoggin Bedard Senior Care Inc 359 Minot Ave Ste C Auburn, ME , TTY: 711 Medicine Shoppe Pharmacy 373 Sabattus St Lewiston, ME , TTY: 711 Aroostook City Drug Store 172 Academy St Presque Isle, ME , TTY: 711 Hebert Rexall Pharmacy 74 Main St Van Buren, ME , TTY: 711 Pharmerica 97 Mcalister Farm Road Portland, ME , TTY: 711 Waltz Long Term Care Pharmacy 3 Business Pkwy Ste 2 Brunswick, ME , TTY: 711 Hancock West End Drug Company 105 Main St Bar Harbor, ME , TTY: 711 Kennebec Mvh Pharmacy 5 Community Dr Ste 3 Augusta, ME , TTY: 711 Mars Hill Pharmacy Inc 106 Main St Mars Hill, ME , TTY: 711 Mvh Pharmacy (External Non Va Bu 5 Community Dr Ste 1 Augusta, ME , TTY: 711 St John Valley LTC 182 Market St Ste 3 Ft Kent, ME , TTY: 711 Cumberland Omnicare of Maine 39 Eisenhower Dr Westbrook, ME , TTY: 711 Penobscot Miller Drug LTC 208 State St , TTY: 711

31 Long-term care pharmacies near you Miller Drug State Street 210 State St , TTY: 711 Patten Drug Company 20 Main St Patten, ME , TTY: 711 Piscataquis Harris Drug 10 Pritham Ave Greenville, ME , TTY: 711 Washington Milbridge Pharmacy 11 Main Street Milbridge, ME , TTY: 711 York Good For All Pharmacy 10 Goodall Dr Ste 800 East Waterboro, ME , TTY: 711 Indian health service/tribal/urban Indian health program (I/T/U) pharmacies near you Only Native Americans and Alaska Natives can use I/T/U pharmacies in the plan s pharmacy network. Other people may be able to use these pharmacies under limited circumstances (for example, emergencies). For more information, please see your Evidence of Coverage. Below are some of the I/T/U network pharmacies in your area. Penobscot Penobscot Nation Hlth Departmnt 23 Wabanaki Way Indian Island, ME , TTY: 711

32 This directory is a partial list of pharmacies available in the plan s pharmacy network. For more information, please call Customer Service at: Toll-Free , TTY a.m. to 8 p.m. local time, Monday through Friday 1 Other pharmacies are available in our network. Members may use any pharmacy in the network, but may not receive Pharmacy Saver pricing. Pharmacies participating in the Pharmacy Saver program may not be available in all areas. 2 Your plan sponsor may provide coverage beyond 90 days. Please refer to the Evidence of Coverage for more information. This information is available for free in other languages. Please call our Customer Service number listed above. Esta información está disponible sin costo en otros idiomas. Comuníquese con el Servicio al Cliente al número indicado arriba. OptumRx is an affiliate of UnitedHealthcare Insurance Company. Beneficiaries must use network pharmacies to access their prescription drug benefit. Formulary, pharmacy network, premium and/or co-payments/coinsurance may change each year. NOTE: If you are receiving Extra Help from Medicare, your co-pays may be lower or you may have no co-pays. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan s contract renewal with Medicare. UHEX15MP _000 Last updated October 2014