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National Home Members Prescription Information Pharmacy Directory
 

PHARMACY DIRECTORY AND LOCATOR TOOL

Pharmacy Directory
There are over 60,000 pharmacies in the extensive Care Improvement Plus Pharmacy network. To locate current network pharmacies in your area click here.

All network pharmacies may not be listed in this directory. Please contact Care Improvement Plus at 1-855-633-4198 (Prospective Members), 1-800-204-1002 (Current Members), or TTY: 711, 7 days a week 8:00am - 8:00pm for additional information.

Network pharmacies*
A network pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits provided by Care Improvement Plus. In most cases, your prescriptions are covered under Care Improvement 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.

Can the list of network pharmacies change?
Yes, Care Improvement Plus may add or remove pharmacies from its pharmacy directory. To get current information about Care Improvement Plus network pharmacies in your area, we suggest you access our pharmacy locator tool.

How do I fill a prescription at a network pharmacy?
To fill your prescription at a network pharmacy, you must show your Care Improvement 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 copay). If this happens, you can ask us to reimburse you for our share of the cost by submitting a claim to us. Click here for the prescription claim reimbursement form or to find out more information on how to submit a claim, please call Member Services at 1-800-204-1002 (Current Members), or TTY: 711, 7 days a week 8:00am - 8:00pm.

How do I fill a prescription through Care Improvement Plus' mail order pharmacy service?
To obtain prescription drugs by mail, use the following Mail Order Form , or call Member Services at 1-800-204-1002 (TTY: 711), 7 days a week, 8:00 am - 8:00 pm. Prescription drugs that you get through any other mail order service are not covered. You can use the Care Improvement Plus mail order service to fill prescriptions for any drug that is on the formulary list. When you order prescription drugs by mail, you may order no more than a 90 day supply of the drug.

Filling prescriptions at a non-network pharmacy
The following are a few exceptions for 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 copay) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a prescription claim form.

You can also call Member Services 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, Member Services 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 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 copay) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a prescription claim form.

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.

Before you fill your prescription in either of these situations, call Member Services 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 above, you will have to pay the full cost (rather than paying just your copay) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a prescription claim form. In order to ensure reimbursement, please submit claim forms no later than 60 days from the date of service.

*Care Improvement Plus has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area.

Click here to access the Medicare Prescription Drug Plan Finder. By clicking this link you are now leaving the Care Improvement Plus website.



This page was last updated on: 6/28/2013 3:20:08 PM

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Additional Information Links State Health Plan Links
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Medicaid / Medicare Special Needs Plans
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Medicare Coverage - Diabetes
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Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Medicare evaluates plans based on a 5-Star rating system. Star ratings are calculated each year and may change from one year to the next.

Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances, and quantity and restrictions may apply. It may cost more to get care from out–of–network providers, except in an emergency. If there isn’t a network provider available for you to see, you can go to an out–of–network provider but still pay the in–network amounts. The health providers in our network can change at any time.

To be eligible for a Care Improvement Plus Regional PPO plan you must be a Medicare beneficiary living in Arkansas, Georgia, Missouri, South Carolina, or Texas and have both Medicare Part A and Part B to enroll.

To be eligible for a Care Improvement Plus Local PPO plan you must be a Medicare beneficiary living in select counties of: Arkansas, Georgia, Illinois, Indiana, Iowa, Missouri, Nebraska, New Mexico, North Carolina, South Carolina, Texas or Wisconsin and have both Medicare Part A and Part B to enroll.

To be eligible for a Care Improvement Plus Chronic Conditions Special Needs Plan, you must have diabetes and/or heart failure and/or, cardiovascular disorder. This plan is available to anyone having a qualifying chronic care condition. Members may enroll in the plan only during specific times of the year. Contact Care Improvement Plus for more information. If you have diabetes, heart failure, cardiovascular disorder or Medicaid/Low Income Subsidy, you may qualify to enroll in a Care Improvement Plus Special Needs Plan ANYTIME of the year by exercising a “Special Election Period.

To be eligible for a Care Improvement Plus Dual Advantage Plan, you must be enrolled in state Medicaid and be a dual eligible beneficiary whom the State holds harmless for Part A and Part B cost sharing. This plan is available to anyone who has both medical assistance from the state and from Medicare. If you are a full benefit dual beneficiary and your Part B premium is paid for by the State, you will not be responsible for paying your Part B premium. Premiums, copays, co-insurance and deductibles may vary based on the level of extra help you receive. Please contact the plan for further details.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call:

  • 1–800–MEDICARE (1–800–633–4227). TTY users should call 1–877–486–2048, 24 hours a day/7 days a week;
  • The Social Security Office at 1–800–772–1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1–800–325–0778; or
  • Your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay their prescription drug costs. If eligible, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office, or call Social Security at 1– 800–772–1213.TTY users should call 1–800–325–0778. You can also apply for Extra Help online at www.socialsecurity.gov/prescriptionhelp. If you qualify for Extra Help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. If Medicare pays only a part of this premium, we will bill you for the amount that Medicare doesn’t cover.


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