Gemcare Medicare Plus Pharmacy Directory This booklet provides a list of Gemcare Medicare Plus's network pharmacies. All network pharmacies may not be listed in this directory. Please contact Gemcare Medicare Plus at 1-800-546-5677, 24 hours a day, seven days a week (TTY/TDD Users should call 1-866-706-4759.) for additional information. Pharmacies may have been added or removed from the list after this directory was printed. To get current information about Gemcare Medicare Plus network pharmacies in your area, please visit our Website at www.gemcare.com or call our Customer Services Department at 1-800-546-5677, 24 hours a day, seven days a week. (TTY/TDD Users should call 1-866-706-4759.) H5609_<material_id> <CMS approval date> 1
Introduction This booklet provides a list of Gemcare Medicare Plus's network pharmacies and includes some basic information about how to fill your prescriptions with Gemcare Medicare Plus. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by Gemcare Medicare Plus. In most cases, your prescriptions are covered under Gemcare Medicare Plus only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one, you are not required to continue going to the same pharmacy to fill your prescription, you can go to any of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described later. Can the list of network pharmacies change? Yes, Gemcare Medicare Plus may add or remove pharmacies from our pharmacy directory. To get current information about Gemcare Medicare Plus network pharmacies in your area, please visit our Website at www.gemcare.com or call our Customer Services Department at 1-800-546-5677, 24 hours a day, seven days a week. (TTY/TDD Users should call 1-866-706-4759.) How do I find Gemcare Medicare Plus network pharmacy in my area? You can visit our Website at www.gemcare.com or call our Customer Services at 1-800-546-5677, 24 hours a day, seven days a week. (TTY/TDD Users should call 1-866-706-4759.) How do I fill a prescription at a network pharmacy? To fill your prescription at a network pharmacy, you must show your Gemcare Medicare Plus Member ID card. If you do not have your ID card with you when you fill your prescription, you may have to pay the full cost of the prescription (rather than paying just your co-payment). If this happens, you can ask us to reimburse you for our share of the cost by submitting a claim to us. To find out how to submit a claim, look in your Evidence of Coverage or call our Customer Services. 2
How do I fill a prescription through Gemcare Medicare Plus's mail order pharmacy service? To get order forms and information about filling your prescriptions by mail, please contact Integrated Pharmacy Services at 1-800-633-7928 (TTY users should call 1-866-706-4757) Monday - Friday 8am - 6pm CST and Saturdays 8am - 12noon or via mail at PO Box 369 Boys Town, NE 68010. Please note that you must use the Gemcare Medicare Plus mail order service. Prescription drugs that you get through any other mail order service are not covered. You are not required to use mail order prescription drug services to obtain an extended supply of maintenance medications. Instead, you have the option of using a retail pharmacy in our network to obtain a supply of maintenance medications. Some retail pharmacies may agree to accept the mail order reimbursement rate for an extended supply of medications for up to 92 days per dispensing, which may result in no out-of-pocket payment difference to you. Please look in the Evidence of Coverage or call our Customer Services Department at 1-800-546-5677 and TTY/TDD 1-866-706-4759 for more information. The maximum expected turnaround time for the processing and shipment of all mail orders is five business days for orders that do not require a call to the prescriber or have a medication that is backordered. If for some reason your medication order from the mail order becomes delayed, you may always obtain a prescription from a local network pharmacy. 3
Filling prescriptions outside the network Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available. Below are some circumstances when we would cover prescriptions fill at an out-of-network pharmacy. Before you fill your prescription in these situations, call our Customer Services Department, 24 hours a day, seven days a week at 1-800-546-5677 and TTY/TDD 1-866-706-4759 to see if there is a network pharmacy in your area where you can fill your prescription. If you do go to an out-of-network pharmacy for the reasons listed below, you may have to pay the full cost (rather than paying just your co-payment) when you fill your prescription. You can ask us to reimburse you for our of the cost by submitting a claim form. However, even after we reimburse you for our share of the cost, you may pay more for a drug purchased at an out-of-network pharmacy because the out-of-network pharmacy's price is higher than what a network pharmacy would have charged. You should submit a claim to us if you fill a prescription at an out-of-network pharmacy as any amount you pay, consistent with the circumstance listed above, will help you qualify for catastrophic coverage. To learn how to submit a paper claim, please refer to the paper claims process described next. The following are a few exceptions when we will pay for a prescription filled at a pharmacy outside of our network. Getting coverage when you travel or are away from the plan s service area If you take a prescription drug on a regular basis and you are going on a trip, be sure to check your supply of the drug before you leave. When possible, take along all the medication you will need. You may be able to order your prescription drugs ahead of time through our mail order pharmacy service. If you are traveling within the United States and territories and become ill, lose or run out of your prescription drugs we will cover prescriptions that are filled at an out-of-network pharmacy. In this situation, you will have to pay the full cost (rather than paying just your co-payment) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a claim form. If you go to an out-of-network pharmacy, you may be responsible for paying the difference between what we would pay for a prescription filled at an in-network pharmacy and what the out-of-network pharmacy charged for your prescription. To learn how to submit a paper claim, please refer to the paper claims process described later. You can also call Customer Service to find out if there is a network pharmacy in the area where you are traveling. If there are no network pharmacies in that area, Customer Service may be able to make arrangements for you to get your prescriptions from an out-of-network pharmacy. We cannot pay for any prescriptions that are filled by pharmacies outside of the United States 4
and territories, even for a medical emergency. What if I need a prescription because of a medical emergency or because I needed urgent care? We will cover prescriptions that are filled at an out-of-network pharmacy if the prescriptions are related to care for a medical emergency or urgent care. In this situation, you will have to pay the full cost (rather than paying just your co-payment) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a paper claim form. If you go to an out-of-network pharmacy, you may be responsible for paying the difference between what we would pay for a prescription filled at an in-network pharmacy and what the out-of-network pharmacy charged for your prescription. To learn how to submit a paper claim, please refer to the paper claims process described later. Other times you can get your prescription covered if you go to an out-of network pharmacy We will cover your prescription at an out-of-network pharmacy if at least one of the following applies: If you are unable to obtain a covered drug in a timely manner within our service area because there is no network pharmacy within a reasonable driving distance that provides 24 hour service. If you are trying to fill a prescription drug that is not regularly stocked at an accessible network retail or mail-order pharmacy (including high cost and unique drugs). If you are getting a vaccine that is medically necessary but not covered by Medicare Part B and some covered drugs that are administered in your doctor's office. How do I submit a paper claim? When you go to a network pharmacy, your claim is automatically submitted to us by the pharmacy. However, if you go to an out-of-network pharmacy for one of the reasons listed above, the pharmacy may not be able to submit the claim directly to us. When that happens, you will have to pay the full cost of your prescription. When you return home, simply submit your claim and your receipt to the following address: Medicare Part D Paper Claims P.O. Box 407 Boys Town, NE 68010. Upon receipt, we will make an initial coverage determination on the claim. Please refer to your Evidence of Coverage or call Customer Service for more information on initial coverage determinations. 5
For more information For more detailed information about your Gemcare Medicare Plus prescription drug coverage, please review the Evidence of Coverage and Gemcare Medicare Plus's formulary. If you have questions about Gemcare Medicare Plus, please call our Customer Services Department at 1-800-546-5677, 24 hours a day, seven days a week. TTY/TDD Users should call 1-866-706-4759. Or, visit www.gemcare.com. 6
Retail Pharmacies STATE: CA COUNTY: KERN CITY: Arvin ZIP: 93203 Bear Mountain Drug 505 Bear Mountain Blvd Arvin, CA 93203 661-854-5738 CITY: Bakersfield ZIP: 93301 Bakersfield Homecare Pharmacy 2901 H St 661-322-6337 Emanuel Dozier, Md 2129 17th St 661-859-2211 Greggs Pharmacy 600 34th St 661-327-9749 Lee's Clinical Pharmacy 1201 24th St, Ste B-120 661-323-7006 Lee's Mercy Plaza Pharmacy 2323 16th St Ste 100 661-324-2545 Med Mart Pps Pharmacy 2929 F Street 800-500-4633 Medical Pharmacy 1911 17th St 661-327-7524 Mercy Plaza Pharmacy 24th Street 2336 Eye St 661-323-2925 Right Healthcare Pharmacy 1121 W Columbus St 661-322-8382 Rite Aid Pharmacy #5809 1601 23rd St 661-324-8974 Sze K Ho Md 4040 San Dimas Ste A 661-327-3784 Walgreens Pharmacy #3222 40 Chester Ave 661-631-2837 ZIP: 93304 El Tejon Drug 2900 Brundage Lane Bakersfield, CA 93304 661-325-7284 Ming & H Drugs 1717 Ming Ave Bakersfield, CA 93304 661-831-4050 Rite Aid Pharmacy #5811 1425 S H St Bakersfield, CA 93304 661-833-1941 Sav-On Pharmacy #6336 1520 Brundage Lane Bakersfield, CA 93304 661-328-0854 Wal-Mart Pharmacy #1574 2300 White Ln Bakersfield, CA 93304 661-832-7997 Walgreens Pharmacy #3272 3315 S H St Bakersfield, CA 93304 661-396-0634 Wible Pharmacy 2400 Wible Suite 1 Bakersfield, CA 93304 661-835-7979 7
ZIP: 93305 Lee's Niles Drug Store United Drugs #3463 1405 Niles St Bakersfield, CA 93305 661-327-9317 Rufeners Alta Vista Drug 260 Bernard St Bakersfield, CA 93305 661-325-8672 Silver Spray Pharmacy 2191 Niles St Bakersfield, CA 93305 661-327-4248 ZIP: 93306 Longs Drug #215 6249 Niles St Bakersfield, CA 93306 661-366-7291 Longs Drug #270 2690 Mount Vernon Ave Bakersfield, CA 93306 661-872-3821 Rite Aid Pharmacy #5814 2681 Oswell St Bakersfield, CA 93306 661-872-6272 Wal-Mart Pharmacy #1624 2601 Fashion Pl Bakersfield, CA 93306 661-873-8104 Walgreens 24 Hr Pharmacy #3294 2628 Mount Vernon Ave Bakersfield, CA 93306 661-871-3855 Walgreens Pharmacy #3282 3815 Niles St Bakersfield, CA 93306 661-363-7137 Your Drug Store 2303 Niles Pt Bakersfield, CA 93306 661-325-2487 ZIP: 93307 Ideal Pharmacy Services 9905 S Union Ave Bakersfield, CA 93307 661-835-1555 Walgreens Pharmacy #1816 3301 Panama Ln Bakersfield, CA 93307 661-835-9383 ZIP: 93308 Costco Pharmacy #688 3800 Rosedale Hwy 661-852-2642 El Tejon Drug 2819 N. Chester 661-399-2901 Longs Drug #417 4400 Coffee Rd 661-588-1060 North Chester 1822 N Chester Ave 661-399-3337 Oildale Community Health Center Pharmacy 525 Roberts Lane 661-392-7850 Rite Aid #6366 6001 Coffee Rd 661-587-5401 Rite Aid Pharmacy #5815 100 China Grade Loop 661-393-3358 Rite Aid Pharmacy #5816 715 Airport Dr 661-392-7059 Sav-On Pharmacy #6398 6045 Coffee Rd 661-587-2890 8
ZIP: 93309 Comprehensive Blood & Cancer Center 6501 Truxton Ave 661-322-2206 Lees Bfmc Pharmacy 4570 California Ave 661-633-1100 Longs Drug #200 4300 California Ave 661-326-1204 Longs Drug #204 3500 Stine Rd 661-833-0200 Longs Drug #267 5510 Stockdale Hwy 661-322-2045 Rite Aid Pharmacy #5817 8000 White Ln 661-837-2198 Truxton Pharmacy 5925 Truxton Ave 661-324-7979 Walgreens #6756 4306 Ming Ave 661-827-9058 Walgreens Pharmacy #3360 4100 White Ln 661-396-0344 ZIP: 93311 Hina's Mercy Southwest Pharmacy 500 Old River Rd Ste 12 Bakersfield, CA 93311 661-663-0977 Hinas Homecare Pharmacy 9508 Stockdale Hwy #130 Bakersfield, CA 93311 661-664-7979 Longs Drug #239 8200 G Stockdale Hwy Bakersfield, CA 93311 661-832-0982 Rite Aid Pharmacy #6195 9000-A Ming Avenue Bakersfield, CA 93311 661-663-0171 ZIP: 93312 Faast Pharmacy 3400 Calloway Dr Bakersfield, CA 93312 661-410-7979 Rite Aid Pharmacy #6294 2646 Allen Rd Bakersfield, CA 93312 661-587-0275 Rite Aid Pharmacy #6451 1107 Calloway Dr Bakersfield, CA 93312 661-587-6951 Sav-On Pharmacy #6377 13045 Rosedale Hwy Bakersfield, CA 93312 661-587-0158 Save Mart Pharmacy #96 9600 Hageman Rd Bakersfield, CA 93312 661-587-2301 Wal-Mart Pharmacy #2557 8400 Rosedale Hwy Bakersfield, CA 93312 661-588-2378 Walgreens Pharmacy #06526 9550 Hageman Bakersfield, CA 93312 661-587-0838 9
ZIP: 93313 Albertson's Pharmacy #623 3500 Panama Ln Bakersfield, CA 93313 661-827-0398 Costco Pharmacy #643 4900 Panama Lane Bakersfield, CA 93313 661-398-4749 Rite Aid Pharmacy #6303 3225 Panama Ln Bakersfield, CA 93313 661-396-0108 Wal-Mart Pharmacy #4819 5626 Gosford Rd Bakersfield, CA 93313 661-654-8577 Walgreens Pharmacy #7909 4949 Gosford Rd Bakersfield, CA 93313 661-858-0218 CITY: Bakersfiled ZIP: 93301 The Community Pharmacy #3836 1524 27th St Suite 302 Bakersfiled, CA 93301 661-322-5000 CITY: California City ZIP: 93505 California City Pharmacy 8209 California City Bv California City, CA 93505 760-373-9879 Rite Aid Pharmacy #5837 9482 California City Bl California City, CA 93505 760-373-5268 CITY: Delano ZIP: 93215 Cole's Medical Arts Pharmacy 1205 Garces Hwy Delano, CA 93215 661-725-7777 Delano Pharmacy 911 12th St Delano, CA 93215 661-721-7979 Kmart Pharmacy #3945 912 County Line Rd Delano, CA 93215 661-721-7406 Komoto Pharmacy 1017 Ellington St Delano, CA 93215 661-725-9489 Rite Aid Pharmacy #5794 611 Cecil Ave Delano, CA 93215 661-725-1312 CITY: Frazier Park ZIP: 93225 Frazier Park Pharmacy PO Box 250 Frazier Park, CA 93225 661-245-3771 CITY: Kernville ZIP: 93238 The Drug Store 111 Piute Dr Kernville, CA 93238 760-376-2216 CITY: Lake Isabella ZIP: 93240 Mesa Clinical Pharmacy PO Box 1628 Lake Isabella, CA 93240 760-379-6106 Rite Aid Pharmacy #5797 PO Box 3740 Lake Isabella, CA 93240 760-379-5621 CITY: Lamont ZIP: 93241 Medicine Shoppe #317 10130 Main St Ste B Lamont, CA 93241 661-845-3551 CITY: Mc Farland ZIP: 93250 Kern Avenue Pharmacy 143 W Kern Ave Mc Farland, CA 93250 661-792-2198 CITY: Mojave ZIP: 93501 Mojave Pharmacy 16912 Hwy 14` Mojave, CA 93501 661-824-1800 10
CITY: Ridgecrest ZIP: 93555 Center Professional Pharmacy 1109 N China Lake Blvd Ridgecrest, CA 93555 760-446-4141 Rite Aid Pharmacy #5845 840 N China Lake Blvd Ridgecrest, CA 93555 760-375-0220 Sav-On Drugs #6331 927 S China Lake Blvd Ridgecrest, CA 93555 760-384-4020 Wal-Mart Pharmacy #1600 911 S China Lake Blvd Ridgecrest, CA 93555 760-371-4979 Walgreens Pharmacy #9030 101 Drummond Ave Ridgecrest, CA 93555 760-384-2358 CITY: Rosamond ZIP: 93560 Antelope Vally Pharmacy 1431 Rosamond Blvd Rosamond, CA 93560 661-256-8981 Rite Aid Pharmacy #5846 2547 W Rosamond Blvd Rosamond, CA 93560 661-256-1116 Rosamond Pharmacy 1415 Rosamond Blvd #22 Rosamond, CA 93560 661-256-1118 CITY: Shafter ZIP: 93263 Rite Aid Pharmacy #6302 301 Central Avenue Shafter, CA 93263 661-746-4991 Shafter Community Health Center Pharmacy 655 S Central Valley Hwy Shafter, CA 93263 661-746-9194 Shafter Medical Pharmacy 825 S Central Valley Hwy Shafter, CA 93263 661-746-5600 CITY: Taft ZIP: 93268 Kern Street Pharmacy 530 Kern St, Ste D Taft, CA 93268 661-763-4284 Kmart Pharmacy #7287 301 Gardner Field Rd Taft, CA 93268 661-763-5951 Rite Aid Pharmacy #5800 1076 Kern St Taft, CA 93268 661-763-4433 CITY: Tehachapi ZIP: 93561 Albertson's Pharmacy #6347 775 Tucker Rd Tehachapi, CA 93561 661-823-7094 Kmart Pharmacy #4751 710 W Tehachapi Blvd Tehachapi, CA 93561 661-822-3594 Rite Aid Pharmacy #5847 811 Tucker Rd Tehachapi, CA 93561 661-822-9232 Tehachapi Pharmacy 840 Tucker Rd Tehachapi, CA 93561 661-822-7999 Walgreens #07555 1101 W Tehachapi Blvd Tehachapi, CA 93561 661-823-0163 CITY: Wasco 11
ZIP: 93280 Kmart Pharmacy #3968 2785 Hwy 46 Wasco, CA 93280 661-758-8802 Rite Aid Pharmacy #5807 2501 Highway 46 Wasco, CA 93280 661-758-0179 Wasco Medical Center Pharmacy 2101 7th St Wasco, CA 93280 661-758-2263 Sav-On Drugs #9785 2006 W Avenue J Lancaster, CA 93536 661-945-2729 Wal-Mart Pharmacy #1563 44765 Valley Central Wa Lancaster, CA 93536 661-940-8891 Walgreens #6017 2840 W Ave L Lancaster, CA 93536 661-943-8683 Wasco Valley Pharmacy 638 F Street Wasco, CA 93280 661-758-0123 COUNTY: LOS ANGELES CITY: Lancaster ZIP: 93536 CVS Pharmacy #9618 4105 W Avenue L Lancaster, CA 93536 661-722-5784 Quartz Hill Pharmacy 42357 50th St W Ste 101 Lancaster, CA 93536 661-943-4118 Sav-On Drugs #3018 4105 W Avenue L Lancaster, CA 93536 661-722-5784 12
Mail Order Pharmacy Integrated Pharmacy Services 800-633-7928 Home Infusion Pharmacies Are home infusion pharmacies part of Gemcare Medicare Plus's pharmacy network? Gemcare Medicare Plus will cover home infusion therapy if: l Your prescription drug is on Gemcare Medicare Plus's formulary or you have a formulary exception; l Gemcare Medicare Plus has approved your prescription drug for home infusion therapy; and l Your prescription is written by an authorized prescriber. STATE: CA COUNTY: KERN CITY: Bakersfield ZIP: 93308 Option Care Home Iv 1315 Boughton Dr 661-615-6000 13
Long-Term Care Pharmacies Are long-term care pharmacies part of Gemcare Medicare Plus's pharmacy network? In some cases, residents of a long-term care facility may access their prescription drugs through the facility s long-term care pharmacy or another network long-term care pharmacy. STATE: CA COUNTY: KERN CITY: Bakersfield ZIP: 93301 Lee's Mercy Plaza Pharmacy 2323 16th St Ste 100 661-324-2545 ZIP: 93215 Delano Reg Medical Ctr Phcy 1401 Garces Hwy Delano, CA 93215 661-721-5303 Mercy Plaza Pharmacy 24th Street 2336 Eye St 661-323-2925 ZIP: 93308 Option Care Home Iv 1315 Boughton Dr 661-615-6000 ZIP: 93313 Ncs Healthcare Of Bakersfield 4300 Stine Rd Ste 700 Bakersfield, CA 93313 661-398-0691 CITY: Delano 14
Network Pharmacies outside the geographic area We have network pharmacies outside of the service area where you can get your drugs covered as a member of our plan. Please call our call our Customer Services at 1-800-546-5677, 24 hours a day, seven days a week. (TTY/TDD Users should call 1-866-706-4759.) for more information. 15