Pharmacy Program**We have a new pharmacy benefits manager effective 1/1/12. Read the news here.**Commonwealth Care Alliance is a Medicare Part D Prescription contractor. Commonwealth Care Alliance cooperates with network pharmacies in your community in order to provide you with the prescription drug coverage you need. A “network pharmacy” contracts with our Plan and is a pharmacy where you can receive and fill your outpatient prescription drugs. You are not required to use the same pharmacy every time; you can go to any of our network pharmacies. Our PharmaciesCommonwealth Care Alliance has a network of 1,139 contracted pharmacies in Massachusetts and has a national network of 61,022 contracted pharmacies. You will receive a Pharmacy Directory, which will help you find a pharmacy located in your neighborhood. Commonwealth Care Alliance has contracts with pharmacies that equals or exceeds CMS requirements for pharmacy access in our service area. Your PCP or PCT can also assist you in choosing a pharmacy, and, as always, you are free to call our Member Services team at 1-866-610-2273 (TTY users please dial 1-866-322-7357). We are available 24 hours a day, 7 days a week. Our programs offer the option of a mail-order pharmacy service. The drugs available for mail-order service are generally drugs that you take on a regular basis, for a chronic or long-term medical condition. You will receive a drug formulary that indicates which drugs are available for mail order. Many of our network pharmacies offer domestic delivery service. In limited circumstances, we will cover prescriptions filled at an out-of-network pharmacy. These circumstances may be related to travel, urgent or emergency care, or unavailability of a network pharmacy or particular drug. To fill your prescription at a network pharmacy, all you have to do is show your Commonwealth Care Alliance Member ID card. If you do not have the card with you at the pharmacy, you may have to pay the full cost of the prescription. If this happens, you can ask us to reimburse you by submitting a claim to us. To find out how to submit a claim, look in your Evidence of Coverage or call our Member Services team at 1-866-610-2273 (TTY users please dial 1-866-322-7357). We are available 24 hours a day, 7 days a week.
Last Updated 1/1/12 |
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