DIRECTORY Pharmacy. Toll-Free , TTY 711
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1 2016 Pharmacy DIRECTORY This directory is a list of network pharmacies near you. This directory is for Wyoming. For more information, please call Customer Service at: Toll-Free , TTY a.m. to 8 p.m. local time, Monday through Friday Y0066_150908_ Last updated September 18, 2015
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 cover of this directory. Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website. For the most current list of our network pharmacies, please see the cover of this directory for information on how to call 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 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 cover of this directory. You do not have to use the same network pharmacy every time you fill your prescription drugs. 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 plan s Evidence of Coverage for more information. For a complete description of your prescription drug coverage, including how to fill your prescriptions, please see your plan s Evidence of Coverage and Drug List (Formulary). If you have questions about any of the above, including instructions on how to submit claims for prescriptions that you had to fill at a non-network pharmacy, please see the cover of this directory for information on how to call us. Pharmacy Saver Pharmacy Saver is a cost savings prescription drug program available to our plan members. 1 The plan has worked with many of our network pharmacies to offer even lower prices on many common prescription drugs. 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 pharmacy listings on the following pages. symbol in the
3 Mail service pharmacies 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. When you use home delivery from OptumRx, you can have 90-day supplies of your maintenance medication delivered right to your door. With the mail service pharmacy, you generally have lower out-of-pocket co-pays. You may save on a 90-day supply of many of your maintenance medications compared with what you would pay at a network retail pharmacy. 2 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 automatically 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 toll-free at , TTY , 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. To refill your home delivery prescriptions, please call us before you think the drugs you have on hand will run out to make sure your next order is shipped to you in time. If you do not receive your prescription drugs or need to contact us, please call OptumRx toll-free at , TTY , 24 hours, 7 days a week. You can find more information about mail service pharmacies by calling OptumRx at the number listed in the Mail service pharmacies section of this directory. Mail service pharmacies are indicated by a pages. symbol in the pharmacy listings on the following 90-day supply from retail pharmacies You do not have to use a mail service pharmacy to get a 90-day supply of your prescription drugs.
4 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 supply 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 on the following pages. symbol in the pharmacy listings
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. Albertsons/Safeway & Affiliates ACME Albertsons Carrs Jewel Osco Market Street Pavilions Randalls Safeway Shaws Tom Thumb United Vons Duane Reade Food Lion Giant Giant Food Stores Hannaford H-E-B Hy-Vee Kroger & Affiliates Baker s City Market Dillons Fred Meyer Fry s Harris Teeter King Soopers Kroger QFC Ralphs Smith s Martins Publix Sam s Club Stop & Shop Target Thrifty White TTY Walmart Wegmans TTY users should call 711, unless a different phone number is listed. This list may change. For a list of other national pharmacy chains in the network or to check for a pharmacy not listed in this directory, call us at the number located on the cover of this directory.
6 Retail pharmacies, including chain pharmacies near you 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. Albany Kmart Pharmacy 750 North 3rd Street Laramie, WY , TTY: 711 Quality Iv Care 3131 Grand Ave Ste B Laramie, WY , TTY: 711 Ridley's Pharmacy 3112 E Grand Ave Laramie, WY , TTY: 711 Safeway Pharmacy 554 North 3rd Street Laramie, WY , TTY: E Grand Ave Laramie, WY , TTY: Grand Ave Laramie, WY , TTY: 711 Big Horn Basin Pharmacy 405 W C St Basin, WY , TTY: 711 Lovell Drug Company 164 E Main St Lovell, WY , TTY: 925 N 6th St Greybull, WY , TTY: 711 Campbell Coal Coalition Family Pharmacy 430 Medical Arts Court Gillette, WY , TTY: 711 Kmart Pharmacy 2150 South Douglas Hwy Gillette, WY , TTY: 711 Medical Hill Pharmacy 407 Medical Arts Court Ste A Gillette, WY , TTY: 711
7 Retail pharmacies, including chain pharmacies near you (continued) Medicap Pharmacy 501 East Lakeway Road Suite A Gillette, WY , TTY: 711 Osco Pharmacy 2610 S Douglas Hwy Gillette, WY , TTY: 711 Smiths Pharmacy 906 Camel Drive Gillette, WY , TTY: 711 Valley Pharmacy 101 Constitution Ave. Saratoga, WY , TTY: E Cedar St Rawlins, WY , TTY: 711 Converse Clinic Pharmacy 925 West Birch Glenrock, WY , TTY: South Douglas Hwy Gillette, WY , TTY: 711 Safeway Pharmacy 1900 E Richards St Douglas, WY , TTY: S Douglas Hwy Gillette, WY , TTY: 711 Shatto's Frontier Drug 1202 E Richards Douglas, WY , TTY: 711 Carbon City Market Pharmacy 602 Higley Blvd Rawlins, WY , TTY: E Cedar St Rawlins, WY , TTY: E Richards St Douglas, WY , TTY: 711 Crook Vilas Pharmacy 224 Main Street Sundance, WY , TTY: 711
8 Retail pharmacies, including chain pharmacies near you (continued) Fremont Arapahoe Health Center Pharmacy 14 Great Plains Rd Arapahoe, WY , TTY: 711 Fort Washakie Hlth Ctr Pharmacy Blackcoal Dr Bldg 29 Fort Washakie, WY , TTY: 711 Kmart Pharmacy 1960 N Federal Blvd Riverton, WY , TTY: 711 Palace Pharmacy 634 Main St Lander, WY , TTY: 711 Smiths Pharmacy 1200 West Main St Riverton, WY , TTY: North Federal Riverton, WY , TTY: N Federal Blvd Riverton, WY , TTY: 711 Goshen Community Drug 900 W Valley Rd Torrington, WY , TTY: 711 Safeway Pharmacy 708 N Federal Blvd Riverton, WY , TTY: E Valley Rd Torrington, WY , TTY: 711 Safeway Pharmacy 1165 Main St Lander, WY , TTY: 711 Vandel Drug 2041 Main St Torrington, WY , TTY: West Main Street Lander, WY , TTY: 711 Hot Springs 140 US Highway 20 S Thermopolis, WY , TTY: 711
9 Retail pharmacies, including chain pharmacies near you (continued) Vicklund Pharmacy 610 S 6th St Thermopolis, WY , TTY: 711 Johnson Buffalo Prescription Shop 431 Fort St Buffalo, WY , TTY: 711 Hoys Hospital Pharmacy 2301 House Avenue Ste , TTY: 711 King Soopers Pharmacy 3702 Dell Range Blvd , TTY: 711 Johnson County Memorial Hospital 497 W Lott St Buffalo, WY , TTY: Harmony St Buffalo, WY , TTY: 711 Laramie Genoa Healthcare 2526 SEymour Ave , TTY: 711 Kmart Pharmacy 1840 Dell Range Blvd Cheyenne, WY , TTY: 711 Medicap Pharmacy 1947 Bluegrass Circle Cheyenne, WY , TTY: 711 North Star Pharmacy and Infusion 7124 Commons Drive Suite B Cheyenne, WY , TTY: 711 Healthworks 2508 E Fox Farm Rd Ste 1B Cheyenne, WY , TTY: 711 Osco Pharmacy 5800 N Yellowstone Rd Cheyenne, WY , TTY: 711 Hoys Drug 1115 E Pershing Blvd , TTY: 711 Osco Pharmacy 3355 E Pershing Blvd , TTY: 711
10 Retail pharmacies, including chain pharmacies near you (continued) Safeway Pharmacy 400 Cole Center , TTY: 711 Walmart Pharmacy 580 Livingston Ave Cheyenne, WY , TTY: 711 Safeway Pharmacy 700 S Greeley Hwy Cheyenne, WY , TTY: 711 Sam's Club Pharmacy 1948 Dell Range Blvd Cheyenne, WY , TTY: 711 Town and Country Pharmacy 514 S Greeley Hwy Cheyenne, WY , TTY: Dell Range Blvd Cheyenne, WY , TTY: E Lincolnway , TTY: Dell Range Blvd Cheyenne, WY , TTY: 711 Lincoln Broulims Pharmacy 141 N. Washington St Afton, WY , TTY: 711 Our Valley Pharmacy 118 Peterson Pkwy Thayne, WY , TTY: 711 Ridley's Pharmacy 620 Pine Ave Kemmerer, WY , TTY: S Washington Street Afton, WY , TTY: 711 Natrona Emissary Pharmacy and Infusion S 2546 E Second St 100 Casper, WY , TTY: 711 Family Pharmacy 1522 E A St Casper, WY , TTY: 711
11 Retail pharmacies, including chain pharmacies near you (continued) Kmart Pharmacy 4000 East 2nd St Casper, WY , TTY: East 2nd Street Casper, WY , TTY: 711 Osco Pharmacy 1076 Cy Ave Casper, WY , TTY: Cy Avenue Casper, WY , TTY: 711 Osco Pharmacy 2625 E 2nd St Casper, WY , TTY: SE Wyoming Blvd Casper, WY , TTY: 711 Ridley's Pharmacy 1375 Cy Ave Casper, WY , TTY: Cy Ave Casper, WY , TTY: 711 Ridley's Pharmacy 300 SE Wyoming Blvd Casper, WY , TTY: 711 Sam's Club Pharmacy 4600 E 2nd St Casper, WY , TTY: 711 Smiths Pharmacy 2405 C Y Ave Casper, WY , TTY: 711 Niobrara Rawhide Drug Company 232 S Main Lusk, WY , TTY: 711 Park Coe Pharmacy 424 Yellowstone Avenue Suite 130 Cody, WY , TTY: 711
12 Retail pharmacies, including chain pharmacies near you (continued) Medical Center Pharmacy 698 Yellowstone Ave Cody, WY , TTY: 711 Osco Pharmacy th St Cody, WY , TTY: 711 Powell Drug Inc 140 N Bent St Powell, WY , TTY: W Coulter Ave Powell, WY , TTY: Yellowstone Avenue Cody, WY , TTY: Sheridan Ave Cody, WY , TTY: 711 West Park Hospital 707 Sheridan Ave Cody, WY , TTY: 711 Platte Register Cliff Pharmacy 437 W Whalen St Guernsey, WY , TTY: th St Wheatland, WY , TTY: 711 South Street Pharmacy 1456 South St Wheatland, WY , TTY: 711 Sheridan Hospital Pharmacy Inc 1 S Main St Sheridan, WY , TTY: 711 Hospital Pharmacy West 1333 West 5th Street Suite 107 Sheridan, WY , TTY: 711 Kmart Pharmacy 2571 N Business 90 Sheridan, WY , TTY: 711
13 Retail pharmacies, including chain pharmacies near you (continued) Osco Pharmacy 1865 Coffeen Ave Sheridan, WY , TTY: 711 Ridley's Pharmacy 169 Coffeen Street Sheridan, WY , TTY: Coffeen Ave Sheridan, WY , TTY: Coffeen Ave Sheridan, WY , TTY: 711 Sublette Altitude Drug 709 W Pine Street Pinedale, WY , TTY: 711 Frontier Pharmacy 501 Nichols St Big Piney, WY , TTY: 711 Ridleys Pharmacy 341 East Pine St Pinedale, WY , TTY: 711 Sweetwater Kmart Pharmacy 2450 Foothill Blvd Rock Springs, WY , TTY: 711 Plaza Pharmacy 1411 Dewar Dr Rock Springs, WY , TTY: 711 Rock Springs Iv Center 400 2nd St Ste A1 Rock Springs, WY , TTY: 711 Savon Pharmacy 1323 Dewar Dr Rock Springs, WY , TTY: Bridger Dr Green River, WY , TTY: 711 Smiths Pharmacy 905 Bridger Dr Green River, WY , TTY: 711 Smiths Pharmacy 2531 Foothill Blvd Rock Springs, WY , TTY: 711
14 Retail pharmacies, including chain pharmacies near you (continued) 201 Gateway Blvd Rock Springs, WY , TTY: Hwy 414 Mountain View, WY , TTY: Gateway Blvd Rock Springs, WY , TTY: 711 Smiths Pharmacy 70 Yellow Creek Rd Evanston, WY , TTY: 711 Teton Kmart Pharmacy 510 South Highway 89 Jackson, WY , TTY: 711 Savon Pharmacy 105 Buffalo Way Jackson, WY , TTY: North 2nd Street Evanston, WY , TTY: 711 Washakie Ricker Pharmacy Inc 1801 Big Horn Ave Worland, WY , TTY: 711 Smiths Pharmacy 1425 South Highway 89 Jackson, WY , TTY: S 20th St Worland, WY , TTY: 711 Stone Drug 830 W Broadway Jackson, WY , TTY: 711 Uinta City Drug th St Evanston, WY , TTY: 711 Weston 205 Boyd Ave Newcastle, WY , TTY: 711 Weston County Health Services 1124 Washington Blvd Newcastle, WY , TTY: 711
15 Retail pharmacies, including chain pharmacies near you (continued) Weston County Pharmacy 727A Washington Blvd Newcastle, WY , TTY: 711 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 Mail Service P.O. Box 2975 P.O. Box Mission, KS Phoenix, AZ Toll-free Toll-free TTY TTY Manifest Pharmacy, LLC 1018 South Batesville Road, Bldg 4-A Greer, SC Toll-free orders@manifestrx.com 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.
16 Home infusion pharmacies near you (continued) Albany Quality Iv Care 3131 Grand Ave Ste B Laramie, WY Sweetwater Rock Springs Iv Center 400 2nd St Ste A1 Rock Springs, WY 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. Big Horn Basin Pharmacy 405 W C St Basin, WY Campbell Medical Hill Pharmacy 407 Medical Arts Court Ste A Gillette, WY Converse Shatto's Frontier Drug 1202 E Richards Douglas, WY Goshen Community Drug 900 W Valley Rd Torrington, WY Vandel Drug 2041 Main St Torrington, WY Johnson Buffalo Prescription Shop 431 Fort St Buffalo, WY Johnson County Memorial Hospital 497 W Lott St Buffalo, WY
17 Long-term care pharmacies near you (continued) Laramie Genoa Healthcare 2526 SEymour Ave Park Powell Drug Inc 140 N Bent St Powell, WY Hoys Drug 1115 E Pershing Blvd West Park Hospital 707 Sheridan Ave Cody, WY Hoys Hospital Pharmacy 2301 House Avenue Ste Sheridan Hospital Pharmacy Inc 1 S Main St Sheridan, WY Medicap Pharmacy 1947 Bluegrass Circle Cheyenne, WY Natrona Emissary Pharmacy and Infusion S 2546 E Second St 100 Casper, WY Niobrara Rawhide Drug Company 232 S Main Lusk, WY Hospital Pharmacy West 1333 West 5th Street Suite 107 Sheridan, WY Sublette Ridleys Pharmacy 341 East Pine St Pinedale, WY Teton Stone Drug 830 W Broadway Jackson, WY
18 Long-term care pharmacies near you (continued) Washakie Ricker Pharmacy Inc 1801 Big Horn Ave Worland, WY Weston Weston County Health Services 1124 Washington Blvd Newcastle, WY 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. Fremont Arapahoe Health Center Pharmacy 14 Great Plains Rd Arapahoe, WY Fort Washakie Hlth Ctr Pharmacy Blackcoal Dr Bldg 29 Fort Washakie, WY
19 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 Customer Service number listed above. Esta información está disponible sin costo en otros idiomas. Comuníquese con el Servicio al Cliente al número indicado arriba. Other pharmacies are available in our network. The pharmacy network may change at any time. You will receive notice when necessary. 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. 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. UHEX16PD _000 WY Last updated September 18, 2015
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