icare Family Care Partnership (HMO SNP) Pharmacy Directory

Transcription

1 icare Family Care Partnership (HMO SNP) Pharmacy Directory For more information, please contact us, icare Family Care Partnership Customer Service, at or, for TTY users, , 8:00 am to 8:00 pm, 7 days-a-week, or visit This Pharmacy Directory was updated on October 15, icare Family Care Partnership is a Coordinated Care plan with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in the icare Family Care Partnership depends on contract renewal. This information is available for free in a different format, including large print and Braille. Please call Customer Service at the number listed above if you need plan information in another format or language. H2237_ IC1107 CMS Accepted 361

2 Introduction This booklet provides a list of icare Family Care Partnership s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and icare Family Care Partnership s formulary. When this pharmacy directory refers to we, us, or our, it means Independent Care Health Plan. When it refers to plan or our plan, it means icare Family Care Partnership. 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 icare Family Care Partnership only if they are filled at a network pharmacy or through our 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 printed. 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 October 15, For the most current list, please contact us. Our contact information appears on the front and back cover pages. If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact us. icare Family Care Partnership s Network Pharmacies The network pharmacies in this directory are divided into three categories: Home Infusion Pharmacies Retail Pharmacies Long-Term Care Pharmacies: Residents of a long-term care facility may access their prescription drugs covered under icare Family Care Partnership through the facility s long-term care pharmacy or another network long-term care pharmacy. Mail Order Pharmacy You can get prescription drugs shipped to your home through our network mail order delivery program. For refills of your mail order prescriptions, you have the option to sign up for an automatic refill program. Under this program, we will start to process your next refill automatically when our records show that you should be close to running out of your drug. We will contact you prior to shipping each refill to make sure you are in need of more medication. You can cancel scheduled refills if you have enough of your medication or if your medication has changed. If you choose not to use the auto refill program, please contact us 7-10 days before you think the drugs you have on hand will run out to make sure your next order is shipped to you in time. To opt out of the automatic refill program, please contact us by phone at or, for TTY users, , TRS Relay number. Typically, you should expect to receive your prescription drugs from 3 to 5 days from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact us at , TTY , TRS Relay number, or US Med at Each pharmacy is listed by category in alphabetical order by city and pharmacy name. 362

3 For more information, please contact us, icare Family Care Partnership Customer Service, at or, for TTY users, , 8:00 am to 8:00 pm, 7 days-a-week, or visit This Pharmacy Directory was updated on October 15,

4 HOME INFUSION PHARMACIES Milwaukee County VISITING NURSE ASSOCIATION OF WISCONSIN WALGREENS INFUSION AND RESPIRATORY SERVICES+ Waukesha County CORAM CVS/SPECIALTY INFUSION SERVICES WEST NATIONAL AVE (414) N 113TH ST (414) S MOORLAND RD STE SOUTH WESTRIDGE DRIVE STE 100 (262) (262) Kenosha County GOOD VALUE PHARMACY LTC+ Milwaukee County TH ST STE 203 (262) YE OLDE PHARMACY+ SURETY PRO PHARMACY LLC N PORT WASHINGTON RD 9200 W LAYTON AVE GLENDALE (414) (414) BEHAVIORAL HEALTH PHARMACY+ FAMILY PHARMACY W WATERTOWN PLANK RD 3512 N OAKLAND AVE (414) (414) GENOA HEALTHCARE W BLUEMOUND RD STE B 229 E WISCONSIN AVE STE 601 REMOTE DISPENSING SITE 210 W CAPITOL DR 4545 N 92ND ST 5185 S NINTH ST 9041 W HEATHER AVE 1845 N FARWELL AVE STE W WISCONSIN AVE (414) (414) (414) (414) (414) (800) (414) (414) N MAYFAIR RD STE W AVE 1040 S 70TH ST (414) (414) (414) WISCONSIN AVE (262) SHARP RD WATERFORD (262) (414) HOME CARE MEDICAL INC LONG-TERM CARE PHARMACIES GENOA HEALTHCARE+ HCHM PHARMACY+ LUTHER MANOR PHARMACY+ OMNICARE OF + PHARMERICA+ PHOENIX PHARMACY INC+ WCS CLINIC PHCY+ ASSISTED LIVING PHARMACY SERVICE+ PRESCRIPTIONS PLUS TLS COMMUNITY PHARMACY+ Racine County LAKEVIEW LTC PHARMACY+ LAKEVIEW SPECIALTY HOSPITAL & REHAB Waukesha County PHARMACY W CAPITOL DRIVE LTC PHARMACY+ N85 W15882 APPLETON AVE 364 (262)

5 LINDEN GROVE PHARMACY W NATIONAL AVE PRESCRIPTION CENTER PHARMACY+ 888 THACKERAY TRL STE 101 FHHP SUSSEX+ N65W24838 MAIN ST ALLIANCE PHARMACY SERVICES 407 PILOT CT STE 200 (262) SUSSEX (262) (262) (262) MAIL ORDER PHARMACY US MED INC* NW 79TH AVE (877) RETAIL PHARMACIES Kenosha County AURORA PRESCRIPTION DISPENSING CENTER*+ GOOD VALUE GOOD VALUE PHARMACY LARSENMAYER*+ GOOD VALUE PHARMACY LTC*+ GOOD VALUE PHARMACY MEDCARE WEST*+ KMART SHOPKO WALGREENS* TH ST (262) ND AVENUE TH STREET 3726 NORTH 22ND TH AVE TH ST STE 100 (262) (262) (262) (262) (262) TH AVE STE TH ST STE 203 (262) (262) TH ST STE ND ST RD STREET TH ST TH STREET ND ST 7525 SHERIDAN RD ND STREET TH STREET 7535 N GREEN BAY RD 5 SIXTH TH AVE 3500 BRUMBACK BLVD (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) TH ST PLEASANT PRAIRIE (262) SAMS Milwaukee County WAL-MART PHARMACY* TH AVE TH ST 3300 BRUMBACK BLVD PLEASANT PRAIRIE SALEM SOMERS (262) (262) (262) N GREENBAY ROAD 6020 W BROWN DEER RD 6300 W BROWN DEER RD BROWN DEER BROWN DEER BROWN DEER (414) (414) (414)

6 3201 E LAYTON AVE CUDAHAY (414) AURORA ST LUKE'S SOUTH SHORE*+ KMART 5900 S LAKE DR 5740 S PACKARD AVE 6077 S PACKARD AVENUE 5851 S PACKARD AV 6241 S PACKARD AVE 8661 N PORT WASHINGTON CUDAHY CUDAHY CUDAHY CUDAHY CUDAHY FOX POINT (414) (414) (414) (414) (414) (414) SAMS 8615 N PORT WASHINGTON RD 9200 W LOOMIS RD 5220 WEST RAWSON AVE 7201 S 76TH STREET 6705 SOUTH 27TH ST 7800 S LOVERS LANE RD 7130 S 76TH STREET 9909 W LOOMIS RD 9527 S 27TH ST 6701 SOUTH 27TH STREET FOX POINT (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) GLENDALE (414) MEDPOINT PICK N SAVE* S 27TH ST ROOM N PORT WASHINGTON RD SUITE B W. SILVER SPRINGS RD SUITE W SILVERSPRINGS DR 5400 N PORT WASHINGTON GLENDALE GLENDALE GLENDALE (414) (414) (414) YE OLDE MEDPOINT SURETY PRO PHARMACY LLC*+ PICK N SAVE*+ 13TH STREET PHARMACY LLC*+ AMC 5320 N PORT WASHINGTON RD 6210 W LOOMIS 5301 S. 76TH ST 5233 S 27TH ST 4279 S 76TH ST 9200 W LAYTON AVE 4777 SOUTH 27TH STREET 4405 W LAYTON AVENUE 4688 S 108TH ST 4296 S 76TH ST W LAYTON AVE 5800 S 108TH ST 5860 S 108TH ST 1320 W BURNHAM ST 820 N PLANKINTON AVE GLENDALE GREENDALE GREENDALE HALES CORNERS HALES CORNERS (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) AURORA PHARMACY* 366

7 ASLMC ASLMC ASMC ASMC AURORA PHARMACY+ (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) W GOOD HOPE RD STE 1129 AURORA PRESCRIPTION DISPENSING CENTER* N MAYFAIR RD STE 100 AURORA PRESCRIPTION DISPENSING CENTER*+ 180 W GRANGE AVE (414) BEHAVIORAL HEALTH PHARMACY+ COMMUNITY, A WALGREENS PHARMACY # FAMILY FROEDTERT EAST FROEDTERT EYE INSTITUTE PHARMACY* FROEDTERT HOSPITAL CANCER CENTER FROEDTERT WEST GENOA HEALTHCARE+ GENOA HEALTHCARE+ HAYAT 2801 W KK RIVER PARKWAY 2900 W OKLAHOMA AVE 1020 N 12TH ST 945 N 12TH ST 3355 W FOREST HOME AVE 950 N 12TH ST STE W EDGERTON AVE 2906 S 20TH ST 8428 W SILVER SPRINGS DR 2700 S 60TH ST 1575 N RIVERCENTER DR (414) (414) W WATERTOWN PLANK RD (414) N PLANKINTON AVE STE W FOREST HOME AVE 1650 FARWELL 2607 N DOWNER AVE 3030 W VILLARD AVE 3860 S 27TH STREET 5929 WEST LISBON AVE 6330 NORTH 76TH ST 7550 W PERKINS PLACE 3512 N OAKLAND AVE 9200 W WISCONSIN AVE SUITE 100E (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) N 87TH ST (414) W WISCONSIN AVE STE 200C 9200 W WISCONSIN AVE SUITE 200 W (414) W BLUEMOUND RD STE B 229 E WISCONSIN AVE STE 601 REMOTE DISPENSING SITE 3727 W WISCONSIN AVE 367 (414) (414) (414) (414)

8 HAYAT HAYAT HAYAT HAYAT PHARMACY* 1919 W NORTH AVE 8500 W CAPITOL DR 5928 W. VLIET ST W CAPITOL DR (414) (414) (414) (414) HAYEKS SHOREWOOD 4001 N DOWNER AVE HCHM 210 W CAPITOL DR (414) (414) ISAAC COGGS HERITAGE HLTH CTR*+ LUTHER MANOR METRO MARKET MLK HERTIAGE CLINIC*+ OMNI PHARMACY* PHARMERICA*+ PHOENIX PHARMACY INC*+ PICK N SAVE*+ PICK N SAVE*+ SAMS SETON TOSA UNION SERV U VISITING NURSE ASSOCIATION OF WISCONSIN* WALGREENS* 8200 W SILVER SPRING 4545 N 92ND ST 1123 N VAN BUREN ST 2555 N MLK DRIVE 1134 W NORTH AVE 9041 W HEATHER AVE 1845 N FARWELL AVE STE N 35TH ST 1100 E GARFIELD W SILVER SPRING DR 1818 W NATIONAL AVE 250 W HOLT AVE 3701 S 27TH STREET 7401 W GOOD HOPE RD 8120 W BROWN DEER RD 7701 WEST CALUMET ROAD 2323 N LAKE DR 2950 SOUTH CHASE AVE 8501 WEST BROWN DEER RD 9235 W CAPITAL DR 709 W OKLAHOMA AVE (414) (414) (414) (414) (414) (800) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) WEST NATIONAL AVE 2830 N OAKLAND AVE 1433 W BURNHAM ST 275 W WISCONSIN AVE 2303 N MLKING DR 4520 WEST NORTH 1101 W MITCHELL 3109 KINNICKINNIC 1400 E BRADY 370 E CAPITOL DR 2727 W NORTH AVENUE 6292 SOUTH 27TH ST 5115 W CAPITOL DR (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414)

9 WCS CLINIC PHCY*+ WILKES VILLAGE WISCONSIN HEALTH FUND 4808 HOPKINS 7171 N TEUTONIA AVE 9100 WEST BELOIT 620 W OKLAHOMA AVE 8488 W BROWN DEER RD 3522 WEST WISCONSIN 5201 N 91ST ST 3333 S 27TH 9040 W GOOD HOPE RD 7600 W CAPITOL 2222 W CAPITOL 6707 W HAMPTON AVE 4730 S 27TH ST 6030 W OKLAHOMA ST 3701 S HOWELL AVE 1600 W WISCONSIN 6442 N 76TH ST 2410 W FOREST HOME AVE 2625 W NATIONAL AVE 401 EAST CAPITAL DRIVE 3355 SOUTH 27TH ST W SILVER SPRING DR 5825 WEST HOPE AVENUE 7025 W MAIN ST 3734 W WISCONSIN AVE (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) N MAYFAIR RD (414) W LAYTON AVE STE 150 (414) S 16TH ST ROOM 121 (414) W CHAMBERS ST RM W BURLEIGH ST (414) (414) W BLUEMOUND RD 6462 S 27TH ST 8770 S HOWELL AVE 2320 W RYAN ROAD 8989 S HOWELL AVE 9449 S HOWELL AVE OAK CREEK OAK CREEK OAK CREEK OAK CREEK OAK CREEK (414) (414) (414) (414) (414) (414) THOMPSONS SERV U 1421 E CAPITOL DR SHOREWOOD (414)

10 WALGREENS* 3970 N OAKLAND AVE 4035 N OAKLAND AVE (217) (414) N CHICAGO AVE 2000 E LAYTON AVE 4698 S WHITNALL AVE 220 EAST SUNSET DR SHOREWOOD SHOREWOOD SOUTH SOUTH SOUTH ST FRANCIS ST FRANCIS TH AVE 2985 S CHICAGO AVE ASSISTED LIVING PHARMACY SERVICE*+ FROEDTERT HEALTH PLANK ROAD PHARMACY* KMART SKYWALK SWAN SERV U WALGREENS INFUSION AND RESPIRATORY SERVICES+ KMART PICK N SAVE*+ PRESCRIPTIONS PLUS* SAMS TLS COMMUNITY 1441 N MAYFAIR RD STE DEWEY AVE 7520 W BLUE MOUND RD (414) (414) (414) N MAYFAIR ROAD 3201 N MAYFAIR ROAD 1717 N MAYFAIR RD 6950 W STATE STREET 9000 W WISCONSIN AVE 9130 W NORTH AVE 3900 N 124TH ST 6600 W STATE ST 2275 N MAYFAIR RD W CAPITOL 2656 AVENUE (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) N 113TH ST 3850 N 124TH ST 2424 S 90TH ST 7220 W NATIONAL AVE 7552 W OKLAHOMA AVE 9220 W 6900 WEST AVE W 2625 S 108TH ST 6760 W NATIONAL AVE W AVE 1540 SOUTH 108TH STREET 2600 SOUTH 108TH STREET 1040 S 70TH ST 60TH AND (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (414) (262)

11 2677 S 108TH STREET 8333 W AVE W AVE (414) (414) (414) MILLER PARK WAY WEST (414) W AVE 240 E HAMPTON WEST WHITEFISH BAY (414) (414) DAN FITZGERALD PHARMACY INC*+ Racine County THE PHARMACY STATION*+ 424 E SILVER SPRING DR WHITEFISH BAY (414) MCHENRY ST 210 S PINE ST 1008 AVE 300 S PINE STREET 680 AVE 1901 AVENUE BURLINGTON BURLINGTON BURLINGTON BURLINGTON BURLINGTON BURLINGTON (262) (262) (262) (262) (262) (262) S GREEN BAY RD MOUNT PLEASANT (262) KMART KMART LAKEVIEW LTC 5625 WASHINGTON AVE 8348 WASHINGTON AVE 3900 ERIE ST SUITE SUITE WEST BLVD 2211 S GREEN BAY ROAD 5141 DOUGLAS AVE 517 WISCONSIN AVE MOUNT PLEASANT (262) (262) (262) (262) (262) (262) (262) LAKEVIEW PHCY OF INC*+ NUTRITIONAL DESIGNS AND PHARMACY LLC*+ SHOPKO 516 MONUMENT SQ (262) WASHINGTON AVE STE RAPIDS DR 4801 WASHINGTON AVE 4810 WASHINGTON AVE 819 N MEMORIAL 6125 DURAND AVE 5005 DOUGLAS AVE 3825 DURAND AVE 1920 DOUGLAS AVE 4901 SPRING ST (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) WISCONSIN AVE (262)

12 AURORA PRESCRIPTION DISPENSING CENTER*+ LAKEVIEW SPECIALTY HOSPITAL & REHAB* THE PHARMACY STATION*+ Waukesha County JEROME DRUGS BIG BEND* AURORA PRESCRIPTION DISPENSING CENTER+ METRO MARKET AURORA SPECIALTY AURORA PRESCRIPTION DISPENSING CENTER* SPRING ST (262) SPRING ST 3049 SOUTH OAKES ROAD TH DR STURTEVANT UNION GROVE (262) (262) (262) FORREST LANE SUITE 101 WATERFORD (262) SHARP RD 601 N ST 900 E MAIN ST WATERFORD WATERFORD WATERFORD (262) (262) (262) W230S8715 CLARK ST BIG BEND (262) W NORTH AVE SUITE W BLUEMOUND RD NUMBER 1 (262) (262) W BLUEMOUND RD STE BLUEMOUND RD W BLUEMOUND RD W CAPITOL DR W CAPITOL DRIVE W AVE W BLUEMOUND RD 2205 N CALHOUN W AVE CAPITOL DRIVE (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) W CAPITOL DRIVE W NORTH AVENUE SUITE 390 (414) (262) W HAMPTON AVE STE SUN VALLEY DR 2901 GOLF RD 2863 HERITAGE DRIVE W BLUEMOUND 109 E CAPITAL DR BUTLER DELAFIELD DELAFIELD DELAFIELD ELM GROVE HARTLAND (262) (262) (262) (262) (262) (262) WALNUT RIDGE DR 423 MERTON AVE HARTLAND HARTLAND (262) (262)

13 CARECENTER PHARMACY LLC*+ N84 W AVE STE 1408 W 165 N 5595 CREEKWOOD CROSSING COMMUNITY MEMORIAL HOSPITAL OUTPATIENT W180 N8085 TOWN HALL RD N83 W15550 APPLETON AVE LTC N85 W15882 APPLETON AVE FROEDTERT HEALTH CLINIC W180N8000 TOWN HALL RD N95 W18351 COUNTY LINE RD N95 WEST17707 SHADY LN N83 W15701 APPLETON AV N56 W15501 SILVER SPRING DR N88W15559 MAIN ST MILLER PHARMACY INC*+ AURORA PRESCRIPTION DISPENSING CENTER+ N77W14435 APPLETON AVE 801 N ROCHESTER ST 1010 N ROCHESTER STREET 212 N ROCHESTER ST 250 EAST WOLF RUN S68W15500 JANESVILLE RD STE 100 S 75 W JANESVILLE ROAD PO BOX 26 S 70 W JANESVILLE RD S79 W JANESVILLE RD W159S6530 MOORLAND ROAD W NATIONAL AVE SUITE 100 JEROME DRUGS MUSKEGO* CORAM CVS/SPECIALTY INFUSION SERVICES HOME CARE MEDICAL INC* 5345 S MOORLAND RD STE SOUTH WESTRIDGE DRIVE STE MENOMORRE MUKWONAGO MUKWONAGO MUKWONAGO MUKWONAGO (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) MUSKEGO (414) MUSKEGO MUSKEGO MUSKEGO MUSKEGO (262) (414) (262) (414) (262) (262) (262)

14 IV COMPOUND CENTER OF WISCONSIN LLC* LINDEN GROVE PHARMACY* PHARMACY INC.*+ PICK N SAVE*+ PRN RX* S WESTRIDGE DR W NATIONAL AVE W AVE W NATIONAL AVE W NATIONAL AVE 5478 S WESTRIDGE DR STE B (262) (262) (262) (262) (262) (262) THRIFTY WHITE PHARMACY SOUTH MOORLAND ROAD 2720 S 163RD ST 3855 S MOORLAND RD (262) (262) (262) KMART WEST NATIONAL AVENUE 1284 SUMMIT AVE STE SUMMIT AVENUE 1300 PABST FARMS CIRCLE (262) (262) (262) (262) PRESCRIPTION CENTER PROHEALTH CARE TOBINS 888 THACKERAY TRL STE SUMMIT AVE 1260 A BROWN STREET 1021 SUMMIT AVENUE (262) (262) (262) (262) COSTCO AURORA PHARMACY+ FHHP SUSSEX*+ SHOPKO ALLIANCE PHARMACY SERVICES* AURORA PRESCRIPTION DISPENSING CENTER*+ MEDICAL CENTER MORELAND PLAZA E WISCONSIN AVENUE 443 PEWAUKEE ROAD 2135 SILVERNAIL RD 2160 SILVERNAIL RD 1441 CAPITOL DR 411 PEWAUKEE ROAD AURORA DR STE 100 N65W24838 MAIN ST N66W25201 CTH V V N65 W MAIN ST 405 N WALES RD 320 W SUMMIT AVE 407 PILOT CT STE 200 LAKE PEWAUKEE PEWAUKEE PEWAUKEE PEWAUKEE PEWAUKEE SUMMIT SUSSEX SUSSEX SUSSEX WALES WALES W231 N1440 CORPORATE CT 1130 W. SUNSET DR 1111 DELAFIELD ST SUITE W MORELAND BLVD 1220 W SUNSET DR 1535 E MORELAND BLVD (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262)

15 PROHEALTH CARE PHARMACYSTONERIDGE*+ SAMS VALUCARE N14W23900 STONE RIDGE DR 600 NORTH SPRINGDALE ROAD 1250 W SUNSET DR 2401 KOSSOW ROAD 501 S GRAND AVE E MORELAND BLVD 221 EAST SUNSET DRIVE 601 MEADOWBROOK RD 230 MADISON ST 2700 GRANDVIEW BLVD 2000 S WEST AVE S14W22605 CORAL DRIVE 725 AMERICAN AVE 375 (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262) (262)

16 1555 N. RiverCenter Drive, Suite 206 Milwaukee, WI TTY: Fax: Independent Care Health Plan