Pharmacy Directory. Health Alliance Medicare Guide HMO

Transcription

1 Health Alliance Medicare Guide HMO Pharmacy Directory For more information about Health Alliance Medicare Guide HMO network pharmacies in your area, please visit our website at HealthAllianceMedicare.org or call Health Alliance Medicare Services at , Monday through Friday, 8 a.m. to 8 p.m. TTY/TDD users should call 711 or (Nebraska Relay). The pharmacy directory was updated on 9/1/2013. Benefi ciaries must use network pharmacies to access their prescription drug benefi t. Benefi ts, formulary, pharmacy network, premium and/or coinsurance may change on January 1 of each year. Health Alliance Medicare is an HMO health plan with a Medicare contract. Enrollment in Health Alliance Medicare depends on contract renewal. med-nehmopharmd-0713 H1737_14_10146 Accepted Last Updated 9/1/2013

2 Introduction This booklet provides a list of Health Alliance Medicare Guide HMO network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Health Alliance Medicare Part D Guide HMO Formulary. 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 Health Alliance Medicare only if they are filled at a network pharmacy or through our mailorder 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 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 mean 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 9/1/2013. 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. We have listed these in the directory under Preferred Pharmacies. We call these pharmacies preferred pharmacies, and they may offer lower cost-sharing than other pharmacies. We also list pharmacies that are in our network but are outside the Guide HMO service area. 1

3 PREFERRED PHARMACIES DOUGLAS OMAHA ALEGENT HEALTH AT HOME MEDICAL EQUIPMENT/INFUSION PHARMACY 5428 F ST OMAHA, NE (402) ALEGENT HEALTH LAKESIDE PHARMACY* LAKESIDE HILLS CT OMAHA, NE (402) ALEGENT HEALTH PHARMACY FLORENCE* 8613 N 30TH ST OMAHA, NE (402) ALEGENT HEALTH PHARMACY-132ND AND CENTER* W CENTER RD OMAHA, NE (402) SAMS PHARMACY* L STREET (402) WAL-MART PHARMACY S 167TH ST OMAHA, NE (402) WAL-MART PHARMACY L ST OMAHA, NE (402) WAL-MART PHARMACY* L STREET (402) BIRCH DR OMAHA, NE (402) SOUTH 72ND STREET OMAHA, NE (402) WEST MAPLE ROAD OMAHA, NE (402) WRIGHT ST. OMAHA, NE (402) NORTH 99TH STREET OMAHA, NE (402) POTTAWATTAMIE COUNCIL BLUFFS SAMS PHARMACY* 3221 MANAWA CENTRE DR COUNCIL BLUFFS, IA (712) WAL-MART PHARMACY* 3201 MANAWA DR COUNCIL BLUFFS, IA (712) SARPY BELLEVUE ALEGENT HEALTH BELLEVUE HEALTH CLINIC* 3308 SAMSON WAY BELLEVUE, NE (402) WAL-MART PHARMACY* SOUTH 15TH STREET BELLEVUE, NE (402) TOWNE CENTER DR BELLEVUE, NE (402) *Extended (90-day) supply of maintenance medications available.

4 PREFERRED PHARMACIES SARPY (continued) GRETNA WAL-MART PHARMACY* WICKERSHAM BLVD GRETNA, NE (402) LAVISTA ALEGENT HEALTH PHARMACY - LAVISTA* 8248 S. 96TH STREET LAVISTA, NE (402) PAPILLION ALEGENT HEALTH PAPILLION PHARMACY* S 84TH ST PAPILLION, NE (402) WAL-MART PHARMACY* 8525 S. 71ST ST. PLAZA PAPILLION, NE (402) *Extended (90-day) supply of maintenance medications available. 3

5 RETAIL PHARMACIES DOUGLAS BENNINGTON HEALTH MART PHARMACY* C W HADAN DR BENNINGTON, NE (402) ELKHORN U SAVE PHARMACY* 940 N 204TH AVENUE ELKHORN, NE (402) OMAHA ACCREDO HEALTH GROUP INC P ST (402) AFFINITY BIOTECH 1810 N 203RD ST OMAHA, NE (402) BAKERS PHARMACY* W CENTER RD OMAHA, NE (402) W MAPLE RD OMAHA, NE (402) LAKESIDE HILLS PLAZA OMAHA, NE (402) N 72ND ST OMAHA, NE (402) N 155TH PLAZA OMAHA, NE (402) N 90TH ST OMAHA, NE (402) N 30TH ST OMAHA, NE (402) SADDLECREEK RD OMAHA, NE (402) BERGAN MERCY OUTPATIENT PHARMACY* 7710 MERCY RD OMAHA, NE (402) CORAM SPECIALTY INFUSION SERVICES, AN APRIA HEALTHCARE COMPA MILL VALLEY RD OMAHA, NE (402) COSTCO PHARMACY* W DODGE RD OMAHA, NE (402) CREIGHTON UNIVERSITY MED CTR CLINIC PHARMACY* 601 N 30TH ST OMAHA, NE (402) CVS PHARMACY # 03478* 2609 S 132ND ST OMAHA, NE (402) CVS PHARMACY # 05714* 4840 DODGE ST OMAHA, NE (402) CVS PHARMACY # 06733* 1919 N 90TH ST OMAHA, NE (402) CVS PHARMACY #* U ST (402) *Extended (90-day) supply of maintenance medications available.

6 RETAIL PHARMACIES DOUGLAS (continued) OMAHA (continued) CVS PHARMACY #04929* FORT ST OMAHA, NE (402) CVS PHARMACY #05863* W MAPLE RD OMAHA, NE (402) CVS PHARMACY# 05634* 8315 W CENTER RD OMAHA, NE (402) DARTMED PHARMACY Q STREET OMAHA, NE (402) DEPOT DRUG* 1400 DOUGLAS ST OMAHA, NE (402) DIABETES SUPPLY CENTER OF THE MIDLANDS* 2910 S 84TH ST OMAHA, NE (402) EDS REXALL* 2701 S 10TH ST OMAHA, NE (402) ELMWOOD PHARMACY* 808 SO 52ND OMAHA, NE (402) ESSENTIAL PHARMACY COMPOUNDING* 620 N 114TH ST OMAHA, NE (402) FRED LEROY HEALTH AND WELLNESS CENTER 2602 J ST OMAHA, NE (402) GERIMED INC* 7915 N 30TH ST OMAHA, NE (402) HY VEE DRUGSTORE* 8404 N 30TH STREET OMAHA, NE (402) HY VEE PHARMACY 1* 5150 CENTER OMAHA, NE (402) HY VEE PHARMACY 10* 3410 NORTH 156TH STREET OMAHA, NE (402) HY VEE PHARMACY 2* STONY BROOK BLVD. (402) HY VEE PHARMACY 3* 8809 W CENTER ROAD OMAHA, NE (402) HY VEE PHARMACY 4* FORT STREET OMAHA, NE (402) HY VEE PHARMACY 5* 7910 CASS STREET OMAHA, NE (402) HY VEE PHARMACY 6* 9707 Q STREET OMAHA, NE (402) *Extended (90-day) supply of maintenance medications available. 5

7 RETAIL PHARMACIES DOUGLAS (continued) OMAHA (continued) HY VEE PHARMACY 7 LTC 3505 L STREET OMAHA, NE (402) HY VEE PHARMACY 7* 3505 L STREET OMAHA, NE (402) HY VEE PHARMACY 8* 747 NORTH 132ND STREET OMAHA, NE (402) HY VEE PHARMACY 9* WELCH PLAZA OMAHA, NE (402) HY-VEE DRUGSTORE LTC (7062)* 8404 N. 30TH OMAHA, NE (402) HY-VEE PHARMACY #11 (1478)* 1000 SOUTH 178TH STREET OMAHA, NE (402) IMMANUEL MEDICAL CENTER RETAIL PHARMACY* 6901 N 72ND ST OMAHA, NE (402) KMART PHARMACY4130* 5000 L STREET OMAHA, NE (402) KMART PHARMACY7493* 5808 S 144TH STREET (402) KMART PHARMACY7579* MAPLE ROAD OMAHA, NE (402) KOHLLS PHARMACY* Q ST (402) LEAVENWORTH ST OMAHA, NE (402) S 84TH ST OMAHA, NE (402) DODGE ST OMAHA, NE (402) N 114TH ST OMAHA, NE (402) KOHLLS RXMPSS* 5110 L STREET OMAHA, NE (402) KUBAT PHARMACY* 2401 N ST OMAHA, NE (402) CENTER ST OMAHA, NE (402) MEDICINE MAN PHARMACY 715 N 132ND ST OMAHA, NE (402) MIDWEST SURGICAL HOSPTIAL PHARMACY 7915 FARNAM DR OMAHA, NE (402) *Extended (90-day) supply of maintenance medications available.

8 RETAIL PHARMACIES DOUGLAS (continued) OMAHA (continued) NO FRILLS PHARMACY* 1221 SOUTH 203RD STREET OMAHA, NE (402) ONEWORLD PHARMACY* 4920 S 30TH ST OMAHA, NE (402) PHARMACY EXPRESS* 349 N 78TH STREET OMAHA, NE (402) PHARMERICA 6528 S 118TH ST (888) QUANTUM MED PHARMACY 3744 S 132ND ST OMAHA, NE (402) RXSOLUTIONS STONEGATE CIRCLE OMAHA, NE (402) SEIG PHARMACY* 6655 SORENSEN PKWY OMAHA, NE (402) SHOPKO PHARMACY* W CENTER RD OMAHA, NE (402) S 84TH ST OMAHA, NE (402) N 90TH ST OMAHA, NE (402) STEIER PHARMACY* 6828 N 72ND ST OMAHA, NE (402) SUPER SAVER PHARMACY* 5710 S 144TH ST (402) TARGET PHARMACY* K PLAZA (402) EVANS PLAZA OMAHA, NE (402) WEST CENTER OMAHA, NE (402) NORTH 132ND ST OMAHA, NE (402) N 73RD PLAZA OMAHA, NE (402) DODGE ST OMAHA, NE (402) THE NEBRASKA MED CENTER CLINIC PHCY* NEBRASKA MEDICAL CTR OMAHA, NE (402) U SAVE PHARMACY MAPLE* 2728 N 108TH ST OMAHA, NE (402) U-SAVE PHARMACY* 5011 S 108TH ST (402) *Extended (90-day) supply of maintenance medications available. 7

9 RETAIL PHARMACIES DOUGLAS (continued) OMAHA (continued) WALGREENS #10437* 5225 N 90TH ST OMAHA, NE (910) WALGREENS #11203* BURKE ST OMAHA, NE (402) WALGREENS #11204* MANDERSON ST OMAHA, NE (402) WALGREENS #11205* 6005 N 72ND ST OMAHA, NE (402) WALGREENS #13137* Q ST (402) WALGREENS #15237* 2929 N 60TH ST OMAHA, NE (402) WALGREENS #2472* R PLAZA OMAHA, NE (402) WALGREENS #3186* 3701 NORTH 132ND ST OMAHA, NE (402) WALGREENS #3202* 7202 NORTH 30TH ST OMAHA, NE (402) WALGREENS #3621* 9001 BLONDO STREET OMAHA, NE (402) WALGREENS #4443* 9001 W CENTER RD OMAHA, NE (402) WALGREENS #4772* 3005 LAKE ST OMAHA, NE (402) WALGREENS #4974* 5038 CENTER ST OMAHA, NE (402) WALGREENS #5059* FORT ST OMAHA, NE (402) WALGREENS #5143* 7151 CASS ST OMAHA, NE (402) WALGREENS #5190* 2323 L STREET OMAHA, NE (402) WALGREENS #5360* 5062 S 155TH ST (402) WALGREENS #5741* 3001 DODGE ST OMAHA, NE (402) WALGREENS #5966* 2605 S 171ST ST OMAHA, NE (402) WALGREENS #6802* SPAULDING PLAZA OMAHA, NE (402) *Extended (90-day) supply of maintenance medications available.

10 RETAIL PHARMACIES DOUGLAS (continued) OMAHA (continued) WALGREENS #6936* 4310 AMES AVE OMAHA, NE (402) WALGREENS #6962* 3121 S 24TH ST OMAHA, NE (402) WALGREENS #7272* W CENTER RD OMAHA, NE (402) WALGREENS #7563* 8989 W DODGE RD OMAHA, NE (402) WALGREENS #7693* 225 N SADDLE CREEK RD OMAHA, NE (402) WALGREENS INFUSION SERVICES* JOHN GALT BLVD (402) VALLEY VALLEY LONG TERM CARE PHARMACY 123 1/2 E GARDINER ST VALLEY, NE (402) VALLEY PHARMACY* 123 E GARDINER ST VALLEY, NE (402) POTTAWATTAMIE AVOCA CARLEY DRUG* 102 N ELM ST AVOCA, IA (712) COUNCIL BLUFFS CVS PHARMACY* 545 W. WASHINGTON ST COUNCIL BLUFFS, IA (712) HY VEE DRUGSTORE* 757 W BROADWAY COUNCIL BLUFFS, IA (712) HY VEE PHARMACY 1* 2323 W. BROADWAY COUNCIL BLUFFS, IA (712) HY VEE PHARMACY 2* 1745 MADISON AVENUE COUNCIL BLUFFS, IA (712) KMART PHARMACY3097* 2803 EAST KANESVILLE BLVD COUNCIL BLUFFS, IA (712) MEDICAP PHARMACY* 2201 W BROADWAY COUNCIL BLUFFS, IA (712) OARD-ROSS DRUG INC TH AVE COUNCIL BLUFFS, IA (712) SHOPKO PHARMACY* 3271 MARKETPLACE DR COUNCIL BLUFFS, IA (712) *Extended (90-day) supply of maintenance medications available. 9

11 RETAIL PHARMACIES POTTAWATTAMIE (continued) COUNCIL BLUFFS (continued) SUPER SAVER PHARMACY #12* 1141 N BROADWAY COUNCIL BLUFFS, IA (712) TARGET PHARMACY* 3804 METRO DR COUNCIL BLUFFS, IA (712) UNION PHARMACY* 235 W BROADWAY COUNCIL BLUFFS, IA (712) WALGREENS #3700* 535 E BROADWAY COUNCIL BLUFFS, IA (712) WALGREENS #4405* 2508 W BROADWAY COUNCIL BLUFFS, IA (712) WALGREENS #5306* 301 W BENNETT AVE COUNCIL BLUFFS, IA (712) MINDEN LEHAN PHARMACY* 317 MAIN ST MINDEN, IA (712) OAKLAND OAKLAND PHARMACY* 601 PIONEER AVE. OAKLAND, IA (712) SARPY BELLEVUE BAKERS PHARMACY* 3614 TWIN CREEK DR BELLEVUE, NE (402) GALVIN RD BELLEVUE, NE (402) CVS PHARMACY #* 1701 GALVIN RD S BELLEVUE, NE (402) NEBRASKA MED CTR BELLEVUE PHARMACY* 2510 BELLEVUE MEDICAL CENTER DR STE 100 BELLEVUE, NE (402) SHOPKO PHARMACY* 601 GALVIN RD S BELLEVUE, NE (402) TARGET PHARMACY* 3808 TWIN CREEK DRIVE BELLEVUE, NE (402) WALGREENS #3694* 1802 GALVIN RD S BELLEVUE, NE (402) WALGREENS #5540* 6905 S 36TH ST BELLEVUE, NE (402) YOUR HOMETOWN PHARMACY* 2227 THURSTON CIR BELLEVUE, NE (402) *Extended (90-day) supply of maintenance medications available.

12 RETAIL PHARMACIES SARPY (continued) GRETNA COMMUNITY PHARMACY SERVICES* NORTHSTAR DR GRETNA, NE (402) MCKINNEYS PHARMACY* 215 ENTERPRISE DR GRETNA, NE (402) U SAVE PHARMACY GRETNA* 611 N HIGHWAY 6 GRETNA, NE (402) LA VISTA CVS PHARMACY# 02741* 6901 S 84TH ST LA VISTA, NE (402) WALGREENS #4754* 8380 HARRISON ST LA VISTA, NE (402) OMAHA AMBER PHARMACY* S 152ND ST OMAHA, NE (402) HY-VEE PHARMACY SOLUTIONS* S 152ND STREET OMAHA, NE (402) MEDWELL RX CHALCO VALLEY PKWY STE 101 OMAHA, NE (402) U SAVE PHARMACY* AUDREY ST OMAHA, NE (402) PAPILLION HY VEE PHARMACY* S 73RD ST PAPILLION, NE (402) KOHLLS PHARMACY* 1413 S WASHINGTON PAPILLION, NE (402) TARGET PHARMACY* 718 NORTH WASHINGTON PAPILLION, NE (402) WALGREENS #11355* 9512 S 71ST PLAZA PAPILLION, NE (402) WALGREENS #11356* S 96TH ST PAPILLION, NE (402) SPRINGFIELD SPRINGFIELD DRUG* 205 MAIN ST SPRINGFIELD, NE (402) *Extended (90-day) supply of maintenance medications available. 11

13 HOME INFUSION PHARMACIES For more information about network home infusion pharmacies in your area, please visit our website at HealthAllianceMedicare.org or call Health Alliance Medicare Services at , Monday through Friday, 8 a.m. to 8 p.m. TTY/TDD users should call DOUGLAS OMAHA ACCREDO HEALTH GROUP INC P ST (402) AFFINITY BIOTECH* 1810 N 203RD ST OMAHA, NE (402) ALEGENT HEALTH AT HOME MEDICAL EQUIPMENT/INFUSION PHARMACY 5428 F ST OMAHA, NE (402) CORAM SPECIALTY INFUSION SERVICES, AN APRIA HEALTHCARE COMPA MILL VALLEY RD OMAHA, NE (402) IMMANUEL MEDICAL CENTER RETAIL PHARMACY* 6901 N 72ND ST OMAHA, NE (402) PHARMACY EXPRESS* 349 N 78TH STREET OMAHA, NE (402) WALGREENS INFUSION SERVICES* JOHN GALT BLVD (402)

14 LONG-TERM CARE Residents of a long-term care facility may access their prescription drugs covered under Health Alliance Medicare Guide HMO through the facility's long-term care pharmacy or another network long-term care pharmacy. DOUGLAS BENNINGTON HEALTH MART PHARMACY* C W HADAN DR BENNINGTON, NE (402) OMAHA EDS REXALL* 2701 S 10TH ST OMAHA, NE (402) ELMWOOD PHARMACY* 808 SO 52ND OMAHA, NE (402) GERIMED INC* 7915 N 30TH ST OMAHA, NE (402) HY VEE PHARMACY 7 LTC 3505 L STREET OMAHA, NE (402) HY-VEE DRUGSTORE LTC (7062)* 8404 N. 30TH OMAHA, NE (402) HY-VEE PHARMACY #11 (1478)* 1000 SOUTH 178TH STREET OMAHA, NE (402) IMMANUEL MEDICAL CENTER RETAIL PHARMACY* 6901 N 72ND ST OMAHA, NE (402) KOHLLS PHARMACY* Q ST (402) LEAVENWORTH ST OMAHA, NE (402) S 84TH ST OMAHA, NE (402) DODGE ST OMAHA, NE (402) N 114TH ST OMAHA, NE (402) KOHLLS RXMPSS* 5110 L STREET OMAHA, NE (402) PHARMERICA 6528 S 118TH ST (888) QUANTUM MED PHARMACY 3744 S 132ND ST OMAHA, NE (402) VALLEY VALLEY LONG TERM CARE PHARMACY 123 1/2 E GARDINER ST VALLEY, NE (402)

15 LONG-TERM CARE POTTAWATTAMIE AVOCA CARLEY DRUG* 102 N ELM ST AVOCA, IA (712) COUNCIL BLUFFS UNION PHARMACY* 235 W BROADWAY COUNCIL BLUFFS, IA (712) OMAHA MEDWELL RX CHALCO VALLEY PKWY STE 101 OMAHA, NE (402) PAPILLION KOHLLS PHARMACY* 1413 S WASHINGTON PAPILLION, NE (402) OAKLAND OAKLAND PHARMACY* 601 PIONEER AVE. OAKLAND, IA (712) SARPY BELLEVUE YOUR HOMETOWN PHARMACY* 2227 THURSTON CIR BELLEVUE, NE (402) GRETNA COMMUNITY PHARMACY SERVICES* NORTHSTAR DR GRETNA, NE (402) U SAVE PHARMACY GRETNA* 611 N HIGHWAY 6 GRETNA, NE (402) LA VISTA OMNICARE OF NEBRASKA* S 152ND ST LA VISTA, NE (402)

16 NETWORK PHARMACIES OUTSIDE ILLINOIS CVS PHARMACY SHOP-CVS KMART PHARMACY KMART-4U KROGER PHARMACY MEIJER PHARMACY E-MEIJER PAMIDA PHARMACY SAM'S PHARMACY TARGET PHARMACY RX-TARGET WALGREENS DRUG STORE WALGREENS WAL-MART PHARMACY WAL-MART

17 INDEX A ACCREDO HEALTH GROUP INC...4, 12 AFFINITY BIOTECH...4 AFFINITY BIOTECH*...12 ALEGENT HEALTH AT HOME MEDICAL EQUIPMENT/ INFUSION PHARMACY...12 ALEGENT HEALTH AT HOME MEDICAL EQUIPMENT/ INFUSION PHARMACY...2 ALEGENT HEALTH BELLEVUE HEALTH CLINIC*...2 ALEGENT HEALTH LAKESIDE PHARMACY*...2 ALEGENT HEALTH PAPILLION PHARMACY*...3 ALEGENT HEALTH PHARMACY - LAVISTA*...3 ALEGENT HEALTH PHARMACY FLORENCE*...2 ALEGENT HEALTH PHARMACY-132ND AND CENTER*...2 AMBER PHARMACY* B BAKERS PHARMACY*...4, 10 BERGAN MERCY OUTPATIENT PHARMACY*...4 C CARLEY DRUG*...14 CARLEY DRUG*...9 COMMUNITY PHARMACY SERVICES*... 11, 14 CORAM SPECIALTY INFUSION SERVICES, AN APRIA HEALTHCARE COMPA...12 CORAM SPECIALTY INFUSION SERVICES, AN APRIA HEALTHCARE COMPA...4 COSTCO PHARMACY*...4 CREIGHTON UNIVERSITY MED CTR CLINIC PHARMACY*...4 CVS PHARMACY...15 CVS PHARMACY # 03478*...4 CVS PHARMACY # 05714*...4 CVS PHARMACY # 06733*...4 CVS PHARMACY #*...4, 10 CVS PHARMACY #04929*...5 CVS PHARMACY #05863*...5 CVS PHARMACY# 02741* CVS PHARMACY# 05634*...5 CVS PHARMACY*...9 D DARTMED PHARMACY...5 DEPOT DRUG*...5 DIABETES SUPPLY CENTER OF THE MIDLANDS*...5 E EDS REXALL*...13 EDS REXALL*...5 ELMWOOD PHARMACY*...13 ELMWOOD PHARMACY*...5 ESSENTIAL PHARMACY COMPOUNDING* *Extended (90-day) supply of maintenance medications available.

18 INDEX F FRED LEROY HEALTH AND WELLNESS CENTER...5 G GERIMED INC*...5, 13 H HEALTH MART PHARMACY*...13 HEALTH MART PHARMACY*...4 HY VEE DRUGSTORE*...5, 9 HY VEE PHARMACY 1*...5, 9 HY VEE PHARMACY 10*...5 HY VEE PHARMACY 2*...5, 9 HY VEE PHARMACY 3*...5 HY VEE PHARMACY 4*...5 HY VEE PHARMACY 5*...5 HY VEE PHARMACY 6*...5 HY VEE PHARMACY 7 LTC...13 HY VEE PHARMACY 7 LTC...6 HY VEE PHARMACY 7*...6 HY VEE PHARMACY 8*...6 HY VEE PHARMACY 9*...6 HY VEE PHARMACY* HY-VEE DRUGSTORE LTC (7062)*...13 HY-VEE DRUGSTORE LTC (7062)*...6 HY-VEE PHARMACY #11 (1478)*...13 HY-VEE PHARMACY #11 (1478)*...6 HY-VEE PHARMACY SOLUTIONS* I IMMANUEL MEDICAL CENTER RETAIL PHARMACY*...12, 13 IMMANUEL MEDICAL CENTER RETAIL PHARMACY*...6 K KMART PHARMACY...15 KMART PHARMACY3097*...9 KMART PHARMACY4130*...6 KMART PHARMACY7493*...6 KMART PHARMACY7579*...6 KOHLLS PHARMACY*...13, 14 KOHLLS PHARMACY*... 6, 11 KOHLLS RXMPSS*...13 KOHLLS RXMPSS*...6 KROGER PHARMACY...15 KUBAT PHARMACY*...6 L LEHAN PHARMACY*...10 M MCKINNEYS PHARMACY* MEDICAP PHARMACY*...9 MEDICINE MAN PHARMACY...6 MEDWELL RX... 11, 14 MEIJER PHARMACY...15 MIDWEST SURGICAL HOSPTIAL PHARMACY...6 *Extended (90-day) supply of maintenance medications available. 17

19 INDEX N NEBRASKA MED CTR BELLEVUE PHARMACY*...10 NO FRILLS PHARMACY*...7 O OAKLAND PHARMACY*...14 OAKLAND PHARMACY*...10 OARD-ROSS DRUG INC...9 OMNICARE OF NEBRASKA*...14 ONEWORLD PHARMACY*...7 P PAMIDA PHARMACY...15 PHARMACY EXPRESS*...12 PHARMACY EXPRESS*...7 PHARMERICA...13 PHARMERICA...7 Q QUANTUM MED PHARMACY...13 QUANTUM MED PHARMACY...7 R RXSOLUTIONS...7 S SAM'S PHARMACY...15 SAMS PHARMACY*...2 SEIG PHARMACY*...7 SHOPKO PHARMACY*...7, 9, 10 SPRINGFIELD DRUG* STEIER PHARMACY*...7 SUPER SAVER PHARMACY #12*...10 SUPER SAVER PHARMACY*...7 T TARGET PHARMACY...15 TARGET PHARMACY*... 7, 10, 11 THE NEBRASKA MED CENTER CLINIC PHCY*...7 U U SAVE PHARMACY GRETNA*...14 U SAVE PHARMACY GRETNA* U SAVE PHARMACY MAPLE*...7 U SAVE PHARMACY*... 4, 11 UNION PHARMACY*...14 UNION PHARMACY*...10 U-SAVE PHARMACY*...7 V VALLEY LONG TERM CARE PHARMACY...13 VALLEY LONG TERM CARE PHARMACY...9 VALLEY PHARMACY*...9 W WALGREENS #10437*...8 WALGREENS #11203*...8 WALGREENS #11204*...8 WALGREENS #11205*...8 WALGREENS #11355* *Extended (90-day) supply of maintenance medications available.

20 INDEX WALGREENS #11356* WALGREENS #13137*...8 WALGREENS #15237*...8 WALGREENS #2472*...8 WALGREENS #3186*...8 WALGREENS #3202*...8 WALGREENS #3621*...8 WALGREENS #3694*...10 WALGREENS #3700*...10 WALGREENS #4405*...10 WALGREENS #4443*...8 WALGREENS #4754* WALGREENS #4772*...8 WALGREENS #4974*...8 WALGREENS #5059*...8 WALGREENS #5143*...8 WALGREENS #5190*...8 WALGREENS #5306*...10 WALGREENS #5360*...8 WALGREENS #5540*...10 WALGREENS #5741*...8 WALGREENS #5966*...8 WALGREENS #6802*...8 WALGREENS #6936*...9 WALGREENS #6962*...9 WALGREENS #7272*...9 WALGREENS #7563*...9 WALGREENS #7693*...9 WALGREENS DRUG STORE...15 WALGREENS INFUSION SERVICES*...12 WALGREENS INFUSION SERVICES*...9 WAL-MART PHARMACY...15 WAL-MART PHARMACY WAL-MART PHARMACY WAL-MART PHARMACY*...2, 3 Y YOUR HOMETOWN PHARMACY*...10, 14 *Extended (90-day) supply of maintenance medications available. 19

21 TTY/TDD 711 or HealthAllianceMedicare.org