2018 Pharmacy Directory Blue Cross MedicareRx Value (PDP) SM Blue Cross Medicare Rx Plus (PDP) SM Y0096_BEN_NM_PDPVPHDR18_NM 478900.0918 Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at getbluenm.com/pdp/pharmacies. You may also call Customer Service for updated provider information. This Pharmacy Directory was updated on 09/2018. For more recent information or other questions, please contact Blue Cross MedicareRx SM Customer Service, at 1-888-285-2249 or, for TTY/TDD users, 711. We are open 8:00 a.m.- 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays, or visit getbluenm.com/pdp/pharmacies.
29
Embed
2018 Pharmacy Directory - Health Insurance New … · 2018 Pharmacy Directory Blue Cross MedicareRx Value (PDP) SM Blue Cross Medicare Rx Plus (PDP)SM Y0096_BEN_NM_PDPVPHDR18_NM 478900.0818
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
2018 Pharmacy DirectoryBlue Cross MedicareRx Value (PDP)SM
Blue Cross Medicare Rx Plus (PDP)SM
Y0096_BEN_NM_PDPVPHDR18_NM 478900.0918
Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at getbluenm.com/pdp/pharmacies. You may also call Customer Service for updated provider information.
This Pharmacy Directory was updated on 09/2018. For more recent information or other questions, please contact Blue Cross MedicareRxSM Customer Service, at 1-888-285-2249 or, for TTY/TDD users, 711. We are open 8:00 a.m.- 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays, or visit getbluenm.com/pdp/pharmacies.
i
Blue Cross MedicareRxSM
Pharmacy DirectoryIntroduction
This booklet provides a list of Blue Cross MedicareRx’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 Blue Cross MedicareRx’s formulary.
When this pharmacy refers to “we”, “us”, or “our”, it means HCSC Insurance Services Company (HISC). When it refers to the “plan” or “our” plan, it means Blue Cross MedicareRx.
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 Blue Cross MedicareRx 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 09/2018. 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 for some drugs may be less at pharmacies in this list that offer preferred cost-sharing. We have marked these pharmacies with “SAVE” to distinguish them from other pharmacies in our network that offer standard cost-sharing.
You can get prescription drugs shipped to your home through our network mail order delivery program which is called PrimeMail by Walgreens Mail Service. For more information, please contact us or see the mail order section of this pharmacy directory.
This directory is for the State of New Mexico which includes the area in which you live. However, we cover a larger service area, and there are more pharmacies where your prescriptions may be covered by our Plan. For information on more pharmacies in our plan network not listed in this directory please contact Blue Cross Medicare RxSM Customer Service, at 1-888-285-2249 or, for TTY/TDD users, 711. We are open 8:00 a.m.- 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays, or visit getbluenm.com/pdp/pharmacies.
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-285-2249 (TTY: 711). We are open between 8:00 a.m. and 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-285-2249 (TTY: 711). Nuestro horario es de 8:00 a.m. a 8:00 p.m., hora local, los 7 días de la semana. Si usted llama del 15 de febrero al 30 de septiembre, durante los fines de semana y feriados, se usarán tecnologías alternas (por ejemplo, correo de voz).
ii
We also list pharmacies that are in our network but are outside the State of New Mexico area in which you live. You may also fill your prescriptions at these pharmacies. For more information, please see the section in this pharmacy directory on Network Pharmacies outside the State of New Mexico or contact Blue Cross MedicareRx Customer Service, at 1-888-285-2249 or, for TTY/TDD users, 711. We are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays, or visit getbluenm.com/pdp/pharmacies.
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 Blue Cross MedicareRx. For more information, please see the section in this pharmacy directory on Network Pharmacies outside the State of New Mexico or contact Blue Cross MedicareRx Customer Service, at 1-888-285-2249 or, for TTY/TDD users, 711. We are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays, or visit getbluenm.com/pdp/pharmacies.
Pharmacy Type Retail
Long Term Care
Home Infusion
Extended Supply
Preferred Network
Preferred Extended
Supply Network
Total Number of Pharmacies
65,384 Pharmacies
4,311 Pharmacies
515 Pharmacies
51,092 Pharmacies
17,332 Pharmacies
17,332 Pharmacies
Pharmacies are listed alphabetically by county and city and by type of pharmacy. The types of pharmacies in this directory appear in this order:
• Mail Order Pharmacies• Retail Pharmacies• Long-Term Care Pharmacies• Home Infusion Pharmacies• Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies
Under each listing we also list additional pharmacy features. These features are identified on each page with the following key:
SAVE = Preferred cost-sharing. Drugs from these pharmacies may cost less than other pharmacies in our network.
90 = 90-day supply. These are retail pharmacies that offer an extended (90-day) supply of medications.
24HR = Pharmacy is open 24-hours.
eRX = Pharmacy accepts electronic prescriptions from prescribers.
Mail Order Pharmacy
AllianceRx Walgreens Prime(888) 277-5475 (TTY users: 711)24 hours a day, seven days a weekwww.alliancerxwp.com
You can get prescription drugs shipped to your home through our network mail order delivery program.
For refills of your mail order prescriptions, please contact us 10 to 20 days before you think the drugs youhave on hand will run out to make sure your next order is shipped to you in time.
Typically, you should expect to receive your prescription drugs within 5-8 business days from the timethat the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time,please contact us at: (888) 277-5475, (TTY users: 711), 24 hours a day, seven days a week, or visitwww.alliancerxwp.com.
Chain Pharmacies
Below are chain pharmacies in our network. For locations and phone numbers of stores near you, call thenumbers below (TTY users: 711) or visit the pharmacy website.
ALBUQUERQUE CITY DRUG............ (505) 705-3540205 SILVER AVE SW STE D • 8710290, eRX
ALBUQUERQUE INDIAN HEALTHPHARMACY.........................................(505) 248-7640801 VASSAR DRIVE NE • 8710690
ALBUQUERQUE PHARMACY............(505) 262-5728500 LOUISIANA BLVD NE • 87108eRX
ASPCARES..........................................(505) 908-96237600 JEFFERSON ST NE STE 6 • 87109SAVE, 90, eRX
BEST BUY DRUGS............................. (505) 299-44961445 WYOMING BLVD. NE • 8711290, eRX
BRIOVARX INFUSION SERVICES 308,LLC.......................................................(505) 830-18002420 COMANCHE RD NE • SUITE A5 • 8710790, eRX
CANCER CENTER PHARMACY.........(505) 272-17001201 CAMINO DE SALUD NE • 8710290, eRX
COMMUNITY, A WALGREENS PHARMACY#16544..................................................(505) 313-8080933 SAN MATEO BLVD NE STE 501 • 87108SAVE, 90, eRX
CORAM CVS/SPECIALTY INFUSIONSERVICES........................................... (505) 798-35007400 WASHINGTON ST NE • 87109
COSTCO PHARMACY........................ (505) 332-6602500 EUBANK BLVD SE • 8712390, eRX
ZIA INDIAN HEALTH CLINICPHARMACY.........................................(505) 867-5258155B CAPITAL SQUARE DR • 8705390
ZUNI
ZUNI INDIAN HOSPITALPHARMACY.........................................(505) 782-7521ROUTE 301 NORTH B ST • 8732790
Blue Cross Medicare Rx Network Pharmacies
New Mexico Pharmacy Listing
Long Term Care Pharmacies
For TTY users, please dial 711.Residents of a long-term care facility may access their prescription drugs covered under our plan through thefacility's long-term care pharmacy or another network long-term care pharmacy.
For more information, please see your Evidence of Coverage.
OMNICARE OF ALBUQUERQUE.......(505) 344-97599019 WASHINGTON ST NE SUITE B1 •ALBUQUERQUE • 87113
PHARMERICA..................................... (505) 343-11132720 BROADBENT PKWY NE STE A •ALBUQUERQUE • 87107
RX INNOVATIONS.............................. (505) 881-46017215 WASHINGTON ST NE • ALBUQUERQUE •87109
SHARE 'N CARE PHARMACY........... (505) 864-7471701 DALIES AVE • STE B • BELEN • 87002
THE MEDICINE SHOPPEPHARMACY.........................................(575) 445-00751275 A S SECOND ST • RATON • 87740
VIDA PHARMACY LLC....................... (505) 856-16608500 JEFFERSON ST NE STE D • STE D •ALBUQUERQUE • 87113
ZIA PHARMACY..................................(505) 639-58572820 BROADBENT PKWY NE STE C •ALBUQUERQUE • 87107
Blue Cross Medicare Rx Network PharmaciesNew Mexico Pharmacy Listing
Home Infusion Pharmacies
For TTY users, please dial 711.For more information, please see your Evidence of Coverage.
21
BRIOVARX INFUSION SERVICES 308,LLC.......................................................(505) 830-18002420 COMANCHE RD NE • SUITE A5 •ALBUQUERQUE • 87107
CORAM CVS/SPECIALTY INFUSIONSERVICES........................................... (505) 798-35007400 WASHINGTON ST NE • ALBUQUERQUE •87109
HIT SPECIALISTS............................... (505) 888-650010801 GOLF COURSE NW • ALBUQUERQUE •87114
OPTION CARE.................................... (505) 888-43254374 ALEXANDER BLVD NE • STE A C •ALBUQUERQUE • 87107
Blue Cross Medicare Rx Network Pharmacies
New Mexico Pharmacy Listing
Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies
For TTY users, please dial 711.
Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian HealthProgram (I/T/U) Pharmacies through our plan's pharmacy network. Those other than Native Americans andAlaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies).
For more information, please see your Evidence of Coverage.
SAVE = Preferred cost sharing 24HR = Open 24 hours90 = 90-day supply eRX = Electronic prescribing
DULCE IHS PHARMACY.................... (505) 759-329112000 STONE LAKE RD • DULCE • 8752890
DZILTH NA O DITH HLE HEALTHCENTER...............................................(505) 368-81446 RD 7586 • BLOOMFIELD • 8741390
GALLUP INDIAN MED CENTERPHARMACY.........................................(505) 722-1185516 EAST NIZHONI BLVD • GALLUP • 8730190
ISLETA HEALTH CENTERPHARMACY.........................................(505) 869-44741 SAGEBRUSH ST • ISLETA • 8702290
JEMEZ HEALTH CENTERPHARMACY.........................................(575) 834-7413110 SHEEPSPRINGS RD • JEMEZ PUEBLO •8702490
MESCALERO INDIAN HOSPITALPHARMACY.........................................(575) 464-3844318 ABALONIE LOOP • MESCALERO • 8834090
NORTHERN NAVAJO MEDICAL CENTERPHARMACY.........................................(505) 368-7252HWY 491 NORTH • SHIPROCK • 8742090
PINE HILL HEALTH CENTER.............(505) 775-3933BIA RT 125 • PINE HILL • 87357
PUEBLO OF SANDIA PHARMACY.... (505) 867-4696203 SANDIA DAY SCHOOL RD • BERNALILLO •87004
SAN FELIPE HEALTH CLINIC PHCY.(505) 867-54853 CEDAR ST • SAN FELIPE PUEBLO • SANFELIPE • 8700190
SANTA ANA HEALTH CLINICPHARMACY.........................................(505) 867-249702 C DOVE RD • BERNALILLO • 8700490
SANTA CLARA IHS PHARMACY.......(505) 753-9421ROUTE 5 • ESPANOLA • 8753290
SANTA FE INDIAN HOSPITALPHARMACY.........................................(505) 946-93891700 CERRILLOS RD • SANTA FE • 8750590
Blue Cross Medicare Rx Network Pharmacies
New Mexico Pharmacy Listing
Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies
For TTY users, please dial 711.
Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban Indian HealthProgram (I/T/U) Pharmacies through our plan's pharmacy network. Those other than Native Americans andAlaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies).
For more information, please see your Evidence of Coverage.
SAVE = Preferred cost sharing 24HR = Open 24 hours90 = 90-day supply eRX = Electronic prescribing
23
SANTO DOMINGO PUEBLO HEALTHCENTER...............................................(505) 465-306085 WEST HIGHWAY 22 • SANTO DOMINGO •87052
TOHATCHI HEALTH CENTERPHARMACY.........................................(505) 733-821807 CHOOSGAI • TOHATCHI • 8732590
ZIA INDIAN HEALTH CLINICPHARMACY.........................................(505) 867-5258155B CAPITAL SQUARE DR • ZIA • 8705390
ZUNI INDIAN HOSPITALPHARMACY.........................................(505) 782-7521ROUTE 301 NORTH B ST • ZUNI • 8732790
Y0096_MRK_NM_NDNOTICE17 Accepted 09042016
Blue Cross and Blue Shield of New Mexico complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Blue Cross and Blue Shield of New Mexico does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Blue Cross and Blue Shield of New Mexico:
• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
○ Qualified sign language interpreters
○ Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provides free language services to people whose primary language is not English, such as:
○ Qualified interpreters
○ Information written in other languages
If you need these services, contact Civil Rights Coordinator
If you believe that Blue Cross and Blue Shield of New Mexico has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator, Office of Civil Rights Coordinator, 300 E. Randolph St., 35th floor, Chicago, Illinois 60601, 1-855-664-7270, TTY/TDD: 1-855-661-6965, Fax: 1-855-661-6960, [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Civil Rights Coordinator is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services 200 Independence Avenue, SW
Room 509F, HHH Building Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
478923.0816
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al
Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at getbluenm.com/pdp/pharmacies. You may also call Customer Service for updated provider information.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits and/or co-payments/co-insurance may change on January 1 of each year. The pharmacy network may change at any time. You will receive notice when necessary.
Prime Therapeutics LLC, a separate company, provides pharmacy benefit management services for Blue Cross and Blue Shield of New Mexico.
Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
Prime Therapeutics has contracted with Walgreens, a company independent from Prime Therapeutics and Blue Cross and Blue Shield of New Mexico, to provide mail pharmacy services through the PrimeMail by Walgreens Mail Service; changing to AllianceRx Walgreens Prime in 2018.
Prescription drug plan is provided by Blue Cross and Blue Shield of New Mexico, which refers to HCSC Insurance Services Company (HISC), an Independent Licensee of the Blue Cross and Blue Shield Association. A Medicare-approved Part D sponsor. Enrollment in HISC’s plan depends on contract renewal.
This Pharmacy Directory was updated on 09/2018. For more recent information or other questions, please contact Blue Cross MedicareRxSM Customer Service, at 1-888-285-2249 or, for TTY/TDD users, 711. We are open 8:00 a.m. - 8:00 p.m., local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays, or visit getbluenm.com/pdp/pharmacies.