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1 Pennsylvania Public School Employees Retirement System (PSERS) Health Options Program district OF ColuMbia Directory FOR THE BASIC AND ENHANCED MEDICARE Rx OPTIONS For more information, please contact OptumRx Customer Service at (888) , 24 hours a day, seven days a week, or visit (TTY/TDD users should call (800) ) This Directory was updated on January 1, Introduction This booklet provides a list of the network pharmacies in for the Basic and Enhanced Medicare Rx Options (Employer PDP). To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and the Basic and Enhanced Medicare Rx Options Plans Abridged and Comprehensive Formularies. When this pharmacy directory refers to we, us, or our, it means the Pennsylvania Public School Employees Retirement System (PSERS). When it refers to plan or our plan, it means the Basic or Enhanced Medicare Rx Option. 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 the plan only if they are filled at a network pharmacy or through the 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 produced. 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 January 1, For the most current list, please contact us. Our contact information is above and on the back cover page. listings in this directory: Chains...2 Retail...3 Mail Order...5 Long-Term Care...5 To get current information about participating network pharmacies in your area, please visit the website at or contact OptumRx Customer Service at (888) , 24 hours a day, seven days a week. (TTY/TDD users should call (800) ) 1 CMS Contract Number: E3014
2 CHAIN PHARMACIES Acme Albertson s Baker s Brooks (800) Carrs Quality Centers City Market (877) Costco (800) CVS (800) SHOP-CVS Dillon Pharmacies Dominick s Food 4 Less Fred Meyer (888) Fry s (623) Genuardi s Gerbes Hilander (317) K-Mart Pharmacies (800) King Soopers (877) Kroger (800) Longs (800) Osco Drug Pavilions Pay Less Group (317) Quality Food Centers, Inc. (800) Ralphs Grocery Company (888) Randalls Pharmacies Rite Aid (800) Safeway Sam s Club (800) Sav-on Drugs Shaws/Osco Pharmacies Smith s Food & Drug (888) Target (800) Tom Thumb Vons Walgreens (800) Wal-Mart (800)
3 > Retail Pharmacies alpha Care Drugs LLC 1638 R St Nw Ste 1, (202) apex Care 4047 Minnesota Ave NE, (202) Bioscrip Parmacy th St NW, (202) Capitol Hill Care 650 Pennsylvania Ave SE, (202) Cathedral Care 3000 Connecticut Ave NW, (202) Chartered Medical 3924 Minnesota Ave NE, (202) Chevy Chase 3812 Northampton St NW, (202) Columbia Heights Prof Care Phcy th St NW, (202) New Jersey Ave SE, (202) Virginia Ave NW, (202) Wisconsin Ave NW, (202) Pennsylvania Ave SE, (202) Vermont Ave NW, (202) Pennsylvania Ave NW (202) Lenfant Plz Center SW (202) Connecticut Ave NW, (202) Dupont Circle NW, (202) M St SW, (202) Connecticut Ave NW, (202) E St NW, (202) Naylor Rd SE, (202) Connecticut Ave NW, (202) Massachusetts Ave NW (202) th St NE, (202) Pennsylvania Ave SE (202) Bladensburg Rd NE, (202) Georgia Ave NW, (202) th St SE, (202) Georgia Ave NW, (202) Kennedy St NW, (202) Rhode Island Ave NE (202) P St NW, (202) th St NW, (202) CVS 1000 U Street NW, (202) Columbia Rd NW, (202) th St NE, (202) th St NW, (202) Key day drug supply available
4 > 2000 M St NW, (202) Pennsylvania Ave NW (202) K St NW, (202) Connecticut Ave Nw (202) K St NW, (202) Macarthur Blvd NW, (202) Wisconsin Ave NW, (202) L St NW, (202) Carroll St NW, (202) Connecticut Ave NW, (202) th St NW, (202) th St NW, (202) Wisconsin Ave NW, (202) P St NW, (202) M St NW, (202) Massachusetts Ave NW (202) Ensign At WHC 106 Irving St NW, (202) Foers 2141 K St NW, (202) Foers th St NW, (202) Giant Brentwood Rd NE, (202) Giant Eighth Street NW, (202) Giant Park Road NW, (202) Giant 1535 Alabama Avenue Street, (202) Giant Wisconsin Ave NW, (202) Goodcare 2906 Martin Luther King Jr Ave (202) Grubbs Care 326 E Capitol St SE, (202) Harris Teeter 1631 Kalorama Road NW, (202) Harris Teeter 1350 Potomac Avenue SE, (704) Key Medical Faculty Assoc Phcy 2150 Pennsylvania Ave NW (202) Medicine Shoppe 7814 Eastern Avenue, (202) Morgan Care 3001 P St NW, (202) Morton s 724 E Capitol St NE, (202) Mt Olivet Care & Med Equip 1809 W Virginia Ave NE, (202) Mt Pleasant Care 3169 Mt Pleasant St NW, (202) National Rehab Hosp Phcy 102 Irving St NW, (202) neighborhood Care 1932 Martin Luther King Jr Ave SE, (202) new Hampshire Care 5001 New Hampshire NW, (202) Petworth Care 4809 Georgia Ave NW, (202) Phamily Care 6323 Georgia Ave NW, (202) Pharmacare Specialty th St NW, (202) Universal Building, (202) day drug supply available
5 > Specialty Listings Executive Building, (202) Georgia Avenue NW, (202) H Street NE, (202) U Street NW, (202) New Mexico Avenue NW (202) South Capitol Street SW (202) Rhode Island Avenue (202) rodmans Drug Store 5100 Wisconsin Ave NW, (202) L Street NW, (202) Wisconsin Avenue NW (202) th Street SE, (202) Maryland Ave NE, (202) Davenport Street NW (202) c Rhode Island Ave NE (202) Alabama Ave SE, (202) Connecticut Ave NW, (202) Georgia Avenue NW, (202) Piney Branch Rd, (202) Columbia Rd NW, (202) Seat Pleasant Care 350 Eastern Ave NE, (202) State Care Inc 2041 Martin Luther King Jr Ave (202) Statscript 1125 Spring Rd, (202) Sterling Care 1647 Benning Rd NE, (202) Super Care 1019 H Street NE, (202) Target th Street NW Suite 201, (202) tschiffely Phcy Dupont Cir 1330 Connecticut Ave NW, (202) tschiffely Union Sta Phcy 50 Massachusetts Ave NE (202) tschiffly Phy 19th St th Street NW, (202) Walgreen Drug Store nd Street NW, (202) Wellington Apothecary 1160 Varnum St NE, (202) Mail Order optumrx Customer Service (888) TTY/TDD users: (800) Long-Term Care In some cases, residents of a long-term care facility may access their prescription drugs through their long-term care pharmacy. Medicine Shoppe 7814 Eastern Avenue, (202) new Hampshire Care 5001 New Hampshire Ave NW, (202) For more information, please contact OptumRx Customer Service at (888) , 24 hours a day, seven days a week, or visit (TTY/TDD users should call (800) ) This Directory was updated on January 1, Key day drug supply available Effective as of 1/1/2014
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