Health Options Program

Transcription

1 Pennsylvania Public School Employees Retirement System (PSERS) Health Options Program Pharmacy 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 Pharmacy 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. Pharmacy listings in this directory: Chains...2 Retail...3 Mail Order...6 Home Infusion...6 Long-Term Care...7 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 Pharmacy Albertson s Baker s Pharmacy 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 Pharmacy (623) Genuardi s Gerbes Hilander Pharmacy (317) K-Mart Pharmacies (800) King Soopers (877) Kroger (800) Longs (800) Osco Drug Pavilions Pay Less Pharmacy 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 Aiea > Honolulu Retail Pharmacies AIEA 90 Aiea Medical Pharmacy Aiea Heights Dr # (808) Moanalua Rd Spc (808) Newtown Square Pharmacy Inc Kaahumanu St, (808) Moanalna Rd, (808) Pharmacy Partners Hi Dba Pharmacare Aiea Heights Dr, (808) Aiea Heights Dr, (808) ELEELE 4469 Waialo Road, (808) Ewa Beach Fort Weaver Rd, (808) Ft Weaver Rd Ste (808) Haiku 90 Haiku Pharmacy 810 Haiku Rd #127, (808) Haleiwa Kamehameha Highway, (808) Hilo 90 Kta Puainako Pharmacy 50 E Puainako St, (808) Hilo Pharmacy 82 Puuhonu Pl, (808) Kilauea Ave, (808) E Puainako St, (808) Mina Pharmacy 1251 Kilauea Avenue, (808) Mina Pharmacy LTC 1251 Kilauea Avenue, (808) East Puainako, (808) Shiigi Drug Company 333 Kilauea Ave, (808) ululani Pharmacy 868 Ululani St #107, (808) Makaala St, (808) Honokaa Hamakua Family Pharmacy Inc a Ste #4 Mamane St (808) Honolulu Aina Haina Rx Pharmacy 850 W Hind Dr #111, (808) Apos Farmacia Inc 634 Kalihi St Rm 204, (808) Century Square Pharmacy 1188 Bishop St #2303, (808) Chinatown Pharmacy 70 N Hotel St, (808) City Pharmacy 966 Kaheka St, (808) City Pharmacy Kapahulu Inc 750 Palani Ave, (808) A Keohole Street, (808) Gulick Pharmacy 2070 N King St, (808) Holiday Mart Drugs 801 Kaheka St, (808) Kmart Pharmacy North Nimitz Hwy, (808) Kmart Pharmacy Salt Lake Blvd, (808) Kuhio Pharmacy 2330 Kuhio Ave, (808) Pali Highway, (808) Key day drug supply available

4 Honolulu > Kailua 330 Sand Island Access Road, (808) Bishop St, (808) Waialae Ave, (808) N School St, (808) Ala Moana Center, (808) Woodlawn Dr, (808) Waialae Ave, (808) Keahole St, (808) S King St, (808) Ala Lilikoi St, (808) Medipharm Pharmacy 50 S Beretania St, (808) Kapiolani Blvd, (808) S King St, (808) N School St, (808) Liliha St Ste 100, (808) Punahou St, (808) S King St, (808) Ii 3375 Koapake, (808) Pharmacyone 1712 Liliha St Ste 101, (808) Plaza Pharmacy 321 N Kuakini St, (808) Professional Plaza Pharmacy 1520 Liliha St #201, (808) Queens Pob 2 Pharmacy 1329 Lusitana St #101, (808) Queens Rx Pharmacy 1380 Lusitana St, (808) Kapahulu Avenue, (808) S Beretania St, (808) Sams Pharmacy 750 Ke Eaumoku St, (808) Liliha St, (808) S Beretania St, (808) st Ave, (808) S King St, (808) Walgreens Drug Store 1488 Kapiolani Boulevard, (808) Keeaumoku St, (808) Wellness Pharmacy Inc 100 N Beretania St #148, (808) iwilei 525 Ala Kawa Street, (808) Kahului 540 Haleakala Highway, (808) Kmart Pharmacy Dairy Road, (808) E Kaahumanu Ave, (808) Maui Clinic Pharmacy 53 S Puunene Ave (808) E Kamehameha Ave (808) Pakaula Street, (808) Kailua 90 CVS Procare Pharmacy 970 North Kalaheo Avenue (808) Foodland Medicine Cabinet Phcy 108 Hekili St, (808) Holiday Mart Drug 345 Hahani St, (808) Key day drug supply available

5 Kailua > Lihue ipc Pharmacy Kailua 30 Aulike St, (808) Koolau Pharmacy 642 Ulukahiki St, (808) Kailua Rd, (808) Palani Rd, (808) Alii Drive Suite H, (808) Hamakua Drive, (808) Kailua Rd, (808) Kailua Kona Maiau St, (808) Kta Keauhou Pharmacy Alii Dr, (808) Henry Street, (808) Kalaheo 90 Kalaheo Pharmacy 4489 Paplina Rd, (808) Papalina Pharmacy 4469 Papalina Rd #948, (808) Kamuela 90 Foodland Medicine Cabinet Parker Ranch Ctr #109, (808) Kta Kamuela Pharmacy Mamalahoa, (808) Village Pharmacy Kawaihae Rd, (808) Kaneohe Castle Professional Ctr Phcy Kamehameha Hwy # (808) Kamehameha Hwy (808) Kaneohe Bay Dr, (808) Kamehameha Hwy (808) Temple Valley Hui Iwa St, (808) Kapaa 4831 Kuhio Highway, (808) Kuhio Hwy, (808) Shoreview Pharmacy 1177 Kuhio Hwy #113, (808) Kapaau 90 Kamehameha Pharmacy LLC Akoni Pule Hwy, (808) Kapolei 90 Kmart Pharmacy Kamokila Blvd, (808) Farrington Hwy (808) Farrington Hwy Ste (808) Kaunakakai Molokai Drugs Inc 28 Kamoi St, (808) Kealakekua 90 Oshima Drug Malahoa Hwy, (808) Kihei Kihei Professional Pharmacy 41 Lipoa, (808) S Kihei Rd, (808) Piikea Avenue, (808) Kihei,Maui 90 Star Market Pharmacy 1310 S Kihei Rd, (808) Kona 90 Kmart Pharmacy Kamakaeha Avenue (808) Lahaina 1221 Honoapiilani Hwy, (808) Laie Foodland Pharmacy Kamehameha Highway, (808) Lihue 90 Ho Ola Lahui Hawai I 3501 Rice St Ste 209, (808) Lifeway Pharmacy Lihue Kuhio Hwy, (808) Lihue Pharmacy Inc 4484 Pahee St, (808) Key day drug supply available

6 Lihue > Specialty Listings Kaumualii Hwy (808) Kuhio Hwy, (808) Mililani Town 94780a Meheula Pkwy, (808) d Meheula Pkwy, (808) PAHALA Ksmsni Street, (808) Pahoa 90 Pahoa Rx Pharmacy 1 Government Rd, (808) Pearl City 850 Kamehameha Hwy, (808) Sams Pharmacy 1000 Kamehameha Hwy#1 Ste#100, (808) Kaahumanu St, (808) Kuala Street, (808) Pukalani 90 Foodland Super Market Pukalani 55 Pukalani St, (808) Wahiawa 925 California Ave, (808) California Avenue, (808) Waianae Farrington Hwy, (808) Waianae Drug Farrington Hwy # (808) waikoloa Waikoloa Pharmacy PO Box , (808) Wailuku 90 Wailuku Professional Pharmacy 1900 Main St, (808) Waimanalo 90 Waimanalo Pharmacy Kalanianaole Hwy (808) Waimea 90 Medcenter Pharmacy 4643 A Waimea Canyon Rd (808) waipahu Ka Uka Blvd, (808) Holiday Mart Drugs Farrington Hwy, (808) Kmart Pharmacy Lumiaina, (808) Farrington Hwy, (808) Farrington Hwy, (808) Kupuohi St, (808) Waipahu Drug #A Hikimoe St, (808) waipahu Family Pharmacy Waipahu St # (808) Waipahu Town Pharmacy Farrington Hwy #B-7b (808) Kupuohi St, (808) Mail Order Pharmacy optumrx Customer Service (888) TTY/TDD users: (800) Home Infusion The Basic and Enhanced Medicare Rx Options will cover home infusion therapy if: Your prescription drug is on the Plan s formulary or a formulary exception has been granted for your prescription drug; You have followed all required coverage rules and our Plan has approved your prescription drug for home infusion therapy; Your prescription is written by a doctor; and You get your home infusion services from a Plan network pharmacy. 6 Key day drug supply available

7 Specialty Listings > Specialty Listings If you have questions, contact OptumRx Customer Service at (888) , 24 hours a day, seven days a week. (TTY/TDD users should call (800) ) KAIlua Caremark Pharmacy Services 970 N Kalaheo Ave, (808) Long-Term Care In some cases, residents of a long-term care facility may access their prescription drugs through their long-term care pharmacy. Kaneohe Pharmerica Kaneohe Keaahala Road, (808) Kealakekua Kona Community Hospital Pharmacy Haukapila St, (808) Lihue Pharmerica Kauai 3420 Kuhio Highway, (808) wailuku Wailuku Professional Pharmacy 1900 Main Street, (808) AIEA 90 Pharmacy Partners Hi Dba Pharmacare Aiea Heights Dr, (808) Hilo Pharmerica Hilo 688 Kinoole Street, (808) Mina Pharmacy LTC 1251 Kilauea Avenue, (808) Honolulu Pharmerica 3375 Koapaka Street Ste H (808) Mina Pharmacy LTC LLC 4510 Salt Lake Boulevard, (808) 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 Pharmacy Directory was updated on January 1, Key day drug supply available Effective as of 1/1/2014