Pharmacy Directory Montana

Transcription

1 MedicareBlue SM Rx (PDP) Pharmacy Directory Montana 2017 This Pharmacy Directory was updated on 09/19/2016. For more recent information or other questions, please contact MedicareBlue Rx at: Individual members call , or for TTY users, 711 Members who purchase through an employer group call , or for TTY users, a.m. to 8 p.m., daily, Mountain Time Or visit: YourMedicareSolutions.com Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website YourMedicareSolutions.com. You may also call Customer Service for updated provider information. S5743_072816_B10_MT Internal Approval 08/30/2016 S5743_072816_GB12_MT Internal Approval 08/30/2016

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3 Introduction This booklet provides a list of MedicareBlue Rx 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 MedicareBlue Rx s Formulary. When this Pharmacy Directory refers to we, us, or our, it means Blue Cross and Blue Shield. When it refers to plan or our plan, it means MedicareBlue Rx. 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 MedicareBlue Rx 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 September 19, 2016 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 P to distinguish them from other pharmacies in our network that offer standard cost sharing. independent company providing pharmacy benefit management services.) This directory is for Montana, 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, contact us at the phone numbers on the front and back cover pages of this directory. 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. MedicareBlue Rx s network pharmacies Our list of network pharmacies is organized by type of pharmacy: Retail, Mail Order, Home Infusion, Long-Term Care and Indian Health Service. Certain letters appear after each pharmacy listing. These letters mean the following: EP = pharmacy supports electronic prescribing EDS = extended day supply available LA = limited access (i.e., pharmacy not available to all members) P = a pharmacy offering preferred cost sharing Network pharmacies outside the service area We have network pharmacies outside of the service area where you can get your drugs covered as a member of our plan. To locate these pharmacies, please contact us. Our contact information appears on the front and back cover pages. You can get prescription drugs shipped to your home through our network mail order delivery program which is called CVS Caremark Mail Order Pharmacy. For more information, please contact us or see the mail order section of this Pharmacy Directory. ( CVS Caremark Part D Services is an

4 Retail pharmacies by city including chain pharmacies LA Limited access (i.e., pharmacy not available to all members) P Pharmacy offering preferred cost sharing EDS Extended day supply available EP Pharmacy supports electronic prescribing ANACONDA COMMUNITY HOSPITAL OF ANACONDA CVS STOKES ANACONDA THRIFTY DRUG STORE ASHLAND BIGHORN VALLEY - ASHLAND BAKER BAKER REXALL DRUG COMPANY BELGRADE LEE & DAD'S BIG SANDY BIG SANDY BIG SKY BOZEMAN DEACONESS PHCY AT BIG SKY BIG TIMBER COLE DRUG 401 W PENNSYLVANIA ST, ANACONDA E PARK AVE, ANACONDA W PARK AVENUE, ANACONDA E PARK AVE, ANACONDA MAIN STREET, ASHLAND S MAIN, BAKER JACKRABBIT LN, BELGRADE W MADISON AVE, BELGRADE JOHANNES AVE, BIG SANDY CENTER LANE STE 2, BIG SKY MCLEOD, BIG TIMBER (406) EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP 2

5 Retail pharmacies by city including chain pharmacies BIG FORK BIGFORK DRUG INC BILLINGS ALBERTSONS ASPEN MEADOWS BILLINGS CLINIC ATRIUM BILLINGS HLTH & REHABILITATION COMMUNITY HEALTH CENTER PHARMA COSTCO CTR FOR HEALTHY AGING PHCY CVS CVS CVS CVS CVS 8111 MT HIGHWAY 35, BIGFORK GRAND AVE, BILLINGS N 27TH ST, BILLINGS CENTRAL AVE, BILLINGS MAIN ST, BILLINGS CENTRAL AVE, BILLINGS GRAND AVE, BILLINGS AVENUE C, BILLINGS TH AVE N, BILLINGS CENTRAL AVE, BILLINGS S 27TH ST # E-1, BILLINGS KING AVE W, BILLINGS MISSION WAY, BILLINGS CENTRAL AVE, BILLINGS GRAND AVE, BILLINGS GRAND AVE, BILLINGS MAIN ST, BILLINGS N 27TH ST, BILLINGS (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP 3

6 Retail pharmacies by city including chain pharmacies BILLINGS CVS FIRST JURO'S UNITED DRUG 617 CENTRAL AVE, BILLINGS TH ST W, BILLINGS GRAND AVE, BILLINGS (406) EDS P EP (406) EDS P EP (406) EDS EP NCS HEALTHCARE OF MONTANA 2747 ENTERPRISE AVE STE 1, BILLINGS LTC TH AVE N STE 110B, BILLINGS ONE TH AVE N STE 110A, BILLINGS SAM'S CLUB SHOPKO ST. JOHN'S LUTHERAN MINISTRIES, INC ST. VINCENTS HEALTHCARE WALGREENS WALGREENS WALGREENS WALGREENS INFUSION SERVICES WALMART WALMART 4420 KING AVE E, BILLINGS S 24TH ST W, BILLINGS RIMROCK RD, BILLINGS N 30TH ST, BILLINGS MAIN ST, BILLINGS GRAND AVE, BILLINGS GRAND AVE, BILLINGS N 31ST ST STE 401, BILLINGS KING AVE W, BILLINGS MAIN ST, BILLINGS (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP (800) EDS EP (406) EDS P EP (406) EDS P EP BOULDER ELKHORN 215 N MAIN, BOULDER (406) EDS P EP 4

7 Retail pharmacies by city including chain pharmacies BOX ELDER ROCKY BOY HEALTH CENTER BOZEMAN 535 CLINIC RD E, BOX ELDER (406) COSTCO CVS HIGHLAND PARK PRICE RITE DRUG CENTER ROSAUERS ROSAUERS SAFEWAY 200 S 23RD AVE, BOZEMAN CATRON RD, BOZEMAN NORTH 19TH AVE, BOZEMAN HIGHLAND BLVD, BOZEMAN N 7TH AVE, BOZEMAN TECHNOLOGY BLVD W, BOZEMAN TECHNOLOGY BLVD W, BOZEMAN W MAIN ST, BOZEMAN SMITH'S 1400 N 19TH AVE, BOZEMAN STUDENT HEALTH SERVICE PHCY WALGREENS INFUSION SERVICES WALMART WESTERN DRUG OF BOZEMAN MONTANA STATE UNIVERSITY, BOZEMAN S FERGUSON AVE STE 1, BOZEMAN N 17TH AVE, BOZEMAN E MAIN ST, BOZEMAN (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP BROADUS BROADUS IGA 120 S PARK AVE, BROADUS (406) EDS EP 5

8 Retail pharmacies by city including chain pharmacies BUTTE BUTTE COMMUNITY HEALTH CENTER PHARM CVS DRISCOLL DRUG KMART MEDICAL ARTS SAFEWAY THREE BEARS WALGREENS WALGREENS INFUSION SERVICES WALMART CHESTER CHESTER REMEDIES & GIFT CHINOOK CHINOOK CHOTEAU CHOTEAU DRUG INC CIRCLE MCCONE COUNTY HEALTH CENTER 445 CENTENNIAL AVE, BUTTE HARRISON AVE, BUTTE S EXCELSIOR AVE, BUTTE HARRISON AVE, BUTTE S CRYSTAL ST STE 230, BUTTE MASSACHUSETTS AVE, BUTTE THREE BEARS DR, BUTTE HARRISON AVE, BUTTE W PLATINUM ST STE D, BUTTE HARRISON AVE, BUTTE MAIN STREET, CHESTER EAST WASHINGTON AVE, CHESTER INDIANA ST, CHINOOK N MAIN AVE, CHOTEAU SULLIVAN AVE, CIRCLE (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (866) EDS EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS 6

9 Retail pharmacies by city including chain pharmacies CLYDE PARK WESTERN DRUG TOO COLSTRIP COLSTRIP FAMILY COLUMBIA FALLS 508 MILES, CLYDE PARK MAIN ST STE B101, COLSTRIP (406) EDS EP (406) EDS EP GOOD MEDICINE TH ST W, COLUMBIA FALLS SMITH'S 419 NUCLEUS AVE, COLUMBIA FALLS (406) EDS P EP (406) EDS P EP COLUMBUS STILLWATER FAMILY CONRAD OLSON'S DRUG VILLAGE DRUG CORVALLIS CORVALLIS DRUG STORE CULBERTSON CULBERTSON CUT BANK DEER LODGE KEYSTONE DRUG SAFEWAY 133 N 5TH, COLUMBUS TH AVE SE, CONRAD S MAIN ST STE 2, CONRAD MAIN ST, CORVALLIS BROADWAY, CULBERTSON W MAIN ST, CUT BANK MAIN ST, DEER LODGE N MAIN ST, DEER LODGE (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP 7

10 Retail pharmacies by city including chain pharmacies DILLON SAFEWAY SHOPKO VANS ENNIS ENNIS EUREKA EUREKA DRUG FAIRFIELD FAIRFIELD DRUG INC FLORENCE FLORENCE NORTH FORSYTH YELLOWSTONE FORT BENTON 570 N MONTANA ST, DILLON E GLENDALE ST, DILLON SOUTHSIDE BLVD, DILLON MAIN ST, ENNIS US HIGHWAY 93 N, EUREKA CENTRAL AVE, FAIRFIELD OLD HWY 93, FLORENCE MAIN ST, FORSYTH (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP BENTON 1418 FRONT ST, FORT BENTON (406) EDS EP FRENCHTOWN GRANITE FRENCHTOWN GARDINER GARDINER BECKWITH ST STE P, FRENCHTOWN PARK ST, GARDINER (406) EDS P EP (406) EDS EP 8

11 Retail pharmacies by city including chain pharmacies GLASGOW 5TH AVENUE AND GIFT SHOPKO WESTERN DRUG OF GLASGOW GLENDIVE F & G GABERT CLINIC KMART GREAT FALLS ANDERSON FAMILY BENEFIS AMBULATORY BIG SKY MANAGED CARE CLINIC CVS KMART PHARMERICA PLAZA 621 3RD ST S, GLASGOW US HIGHWAY 2 W, GLASGOW ND AVE S, GLASGOW HARMON ST, GLENDIVE N MERRILL AVE, GLENDIVE DILWORTH ST, GLENDIVE W BELL ST, GLENDIVE RD ST NW, GREAT FALLS TH AVE S, GREAT FALLS TH AVE S, GREAT FALLS TH AVE S STE 2, GREAT FALLS ST AVE S STE 110, GREAT FALLS TH ST S, GREAT FALLS TH AVE S, GREAT FALLS RD ST NW, GREAT FALLS TH AVE S, GREAT FALLS TH AVE S, GREAT FALLS (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP 9

12 Retail pharmacies by city including chain pharmacies GREAT FALLS PUBLIC DRUG CO SAM'S CLUB SHOPKO 324 CENTRAL AVE, GREAT FALLS NORTHWEST BYP, GREAT FALLS NORTHWEST BYP, GREAT FALLS SMITH'S 1601 MARKET PLACE DR, GREAT FALLS SNYDER DRUG SPECTRUMS HOME SOLUTIONS WALGREENS WALGREENS WALMART TH AVE N, GREAT FALLS TH AVE S, GREAT FALLS RD ST NW, GREAT FALLS TH AVE S, GREAT FALLS SMELTER AVE NE, GREAT FALLS (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS (406) EDS EP (406) EDS EP (406) EDS P EP HAMILTON BITTERROOT DRUG HEALTHCARE PROVIDERS KMART TIMBER RIDGE WALGREENS HARDIN BIGHORN VALLEY PHARMCARE OF HARDIN INC 1313 N 1ST ST, HAMILTON W MAIN ST, HAMILTON N 1ST ST, HAMILTON N 1ST ST, HAMILTON N 1ST ST, HAMILTON M 1ST ST, HAMILTON WEST 4TH ST SUITE B, HARDIN N CENTER AVE, HARDIN (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP 10

13 Retail pharmacies by city including chain pharmacies HARLEM MILK RIVER HARLOWTOWN REMEDIES AND HARDWARE HAVRE BULLHOOK COMMUNITY HLTH CTR PHCY HEALTH MART KMART NORTHERN MONTANA HOSP NORTHERN MONTANA WALMART WESTERN DRUG HELENA COSTCO CVS CVS CVS GENEVA WOODS GENEVA WOODS US HWY 2, HARLEM N CENTRAL AVENUE, HARLOWTON TH ST, HAVRE ST ST, HAVRE HIGHWAY #2 WEST, HAVRE TH ST, HAVRE TH ST, HAVRE US HIGHWAY 2 W, HAVRE TH AVE STE B, HAVRE E CUSTER AVE, HELENA EUCLID AVE, HELENA N MONTANA AVE, HELENA N MONTANA AVE, HELENA WINNE AVE STE F, HELENA WINNE AVE STE A, HELENA (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP 11

14 Retail pharmacies by city including chain pharmacies HELENA KMART OSCO SAFEWAY SHOPKO ST PETERS COMMUNITY ST PETERS BROADWAY WALGREENS WALMART KALISPELL BIG SKY IV CARE COSTCO EVERGREEN KALISPELL REGIONAL MED CENTER PHCY KMART MEDICAL ARTS ROSAUERS SHOPKO 1700 CEDAR ST, HELENA N MONTANA AVE, HELENA N MONTANA AVE, HELENA N MONTANA AVE, HELENA E BROADWAY ST, HELENA BROADWAY, HELENA TH AVE, HELENA PROSPECT AVE, HELENA W IDAHO ST, KALISPELL FOUR MILE DR STE 3, KALISPELL US HIGHWAY 93 N, KALISPELL HWY 2 EAST STE 300, KALISPELL SUNNYVIEW LN, KALISPELL US HIGHWAY 2 E, KALISPELL CONWAY DR, KALISPELL US HIGHWAY 93 S, KALISPELL HWY 2 E, KALISPELL (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS (406) EDS EP (406) EDS P EP (406) EDS (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP 12

15 Retail pharmacies by city including chain pharmacies KALISPELL SMITH'S 195 3RD AVENUE NE, KALISPELL SYKES INC THE CLINICAL WALGREENS WALMART 202 2ND AVE W, KALISPELL CONWAY DR, KALISPELL W IDAHO ST, KALISPELL HUTTON RANCH RD, KALISPELL (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS P EP LAKESIDE REMEDIES LAKESIDE LAUREL CVS GENES WALMART LEWISTOWN 206 STONER LOOP RD, LAKESIDE SE 4TH ST, LAUREL E MAIN ST, LAUREL BERNHARDT RD, LAUREL (406) EDS P EP (406) EDS P EP (406) EDS (406) EDS P EP 117 W JANEAUX ST, LEWISTOWN SEIDEN DRUG 310 WENDELL AVE STE 102, LEWISTOWN SHOPKO 825 NE MAIN ST, LEWISTOWN (406) EDS P EP (406) EDS P EP (406) EDS P EP LIBBY FRANK'S LIBBY DRUG NORTHWEST COMMUNITY HEALTH CNTR 1401 MINNESOTA AVE, LIBBY MONTANA AVE, LIBBY E 2ND ST, LIBBY (406) EDS P EP (406) EDS (406) EDS P EP 13

16 Retail pharmacies by city including chain pharmacies LIVINGSTON KC WESTERN DRUG LONG TERM CARE PHCY SHOPKO WESTERN DRUG LOLO LOLO DRUG LLC MALTA VALLEY DRUG COMPANY MILES CITY 2120 PARK ST S, LIVINGSTON W PARK ST STE B, LIVINGSTON WASHINGTON ST, LIVINGSTON W PARK STREET, LIVINGSTON GLACIER DR, LOLO SOUTH FIRST AVE E, MALTA S HAYNES AVE, MILES CITY (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP BIG SKY 701 MAIN ST, MILES CITY (406) EDS P EP WALMART MISSOULA BROADWAY COSTCO 3205 STOWER ST, MILES CITY OXFORD ST, MISSOULA N RESERVE ST, MISSOULA S RUSSELL ST, MISSOULA W BROADWAY ST, MISSOULA NORTHERN PACIFIC ST, MISSOULA (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP 14

17 Retail pharmacies by city including chain pharmacies MISSOULA CVS CVS GRANITE MISSOULA GRANITE PHCY HEALTH SOLUTIONS HEALTH SERVICES MISSOULA FRESH MARKET 1914 BROOKS ST, MISSOULA N RESERVE ST, MISSOULA TH AVE W STE 2, MISSOULA TH AVE STE 1, MISSOULA EDDY AVE, MISSOULA S RESERVE ST, MISSOULA (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS P EP MISSOULA FRESH MARKET MISSOULA 800 W BROADWAY ST, MISSOULA S RESERVE ST STE 102, MISSOULA (406) EDS P EP (406) EDS P EP OSCO PALMER'S DRUG PARTNERSHIP HEALTH CENTER ROSAUERS 1003 E BROADWAY ST, MISSOULA SW HIGGINS AVE, MISSOULA W ALDER ST, MISSOULA S RESERVE ST, MISSOULA (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP SAVMOR DRUG I INC 1610 S 3RD ST W, MISSOULA (406) EDS P EP SHOPKO THE VILLAGE HEALTH CARE CENTER PHCY WALGREENS WALGREENS WALMART WALMART 2510 S RESERVE ST, MISSOULA SOUTH AVE W, MISSOULA N RESERVE ST, MISSOULA BROOKS ST, MISSOULA HWY 93 SOUTH, MISSOULA MULLAN RD, MISSOULA (406) EDS P EP (406) EDS EP (406) EDS EP (406) EDS EP (406) EDS P EP (406) EDS P EP 15

18 Retail pharmacies by city including chain pharmacies PHILIPSBURG GRANITE PLAINS PLAINS DRUG PLENTYWOOD PLENTYWOOD DRUG POLSON HEALTHCARE PLUS HEALTHCARE PLUS LTC PROVIDENCE LAKESHORE PROVIDENCE ST JOSEPH SAFEWAY WALGREENS WALMART POPLAR 106 N. MONTGOMERY ST, PHILIPSBURG RAILROAD ST, PLAINS N MAIN ST, PLENTYWOOD HIWAY 93 EAST, POLSON TH AVE E, POLSON A US HWY 93, POLSON TH AVE E, POLSON S SHORE RTE, POLSON MT HIGHWAY 35, POLSON MEMORY LANE, POLSON (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP POPLAR 213 H ST EAST, POPLAR (406) EDS P EP RED LODGE RED LODGE DRUG COMPANY 211 NORTH BROADWAY, RED LODGE (406) EDS P EP 16

19 Retail pharmacies by city including chain pharmacies RONAN FAMILY HEALTH R & R HEALTH CARE SOLUTIONS ROUNDUP SHOPKO SAINT IGNATIUS MISSION DRUG SCOBEY SERVICE DRUG SEELEY LAKE SEELEY SWAN SHELBY NORTHTOWN DRUG LLC SHOPKO SHERIDAN MACS CHC SIDNEY CLINIC SHOPKO WHITE DRUG HWY 93 S, RONAN US HIGHWAY 93 STE B, RONAN MAIN ST, ROUNDUP N MAIN ST, SAINT IGNATIUS MAIN ST, SCOBEY HWY 83, SEELEY LAKE MAIN ST, SHELBY ROOSEVELT HWY, SHELBY N MAIN ST, SHERIDAN TH AVE SW, SIDNEY S CENTRAL AVE, SIDNEY E MAIN ST, SIDNEY (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP (406) EDS P EP 17

20 Retail pharmacies by city including chain pharmacies STEVENSVILLE FAMILY 3804 EASTSIDE HWY, (406) EDS P EP INC STEVENSVILLE RIDGEWAY 39 STEVI CUTOFF RD, (406) EDS P EP STEVENSVILLE VALLEY DRUG & 301 MAIN ST, STEVENSVILLE (406) EDS P EP VARIETY SUPERIOR MINERAL 207 RIVER ST, SUPERIOR (406) EDS EP INC THOMPSON DOUG'S DRUG 1221 MAIN STREET, (406) EDS P EP THOMPSON FALLS THREE FORKS RAILWAY DRUG 117 MAIN STE A, THREE FORKS (406) EDS P EP TOWNSEND TOWNSEND DRUG 308 BROADWAY, TOWNSEND (406) EDS P EP TROY KOOTENAI DRUG 611 E. MISSOULA AVE, TROY (406) EDS EP VICTOR NORTH RIDGE 2824 HWY 93 N STE B, VICTOR (406) EDS EP HEALTHCARE RIDGEWAY 2824 HWY 93 NORTH, VICTOR (406) EDS EP WARM SPRINGS MONTANA STATE 202 GARNET WAY, WARM SPRINGS (406) EDS HOSPITAL WEST YELLOWSTONE SILVERTIP 120 N CANYON ST STE F, (406) EDS P EP WEST YELLOWSTONE

21 Retail pharmacies by city including chain pharmacies WHITE SUIPHER SPRING CASTLE MOUNTAIN 25 E MAIN, WHITE SUIPHUR SPRING (406) EDS P EP DRUG WHITEFISH ALPINE 6475 HWY 93 S, WHITEFISH (406) EDS P EP APOTHECARY NORTH VALLEY 1600 HOSPITAL WAY, WHITEFISH (406) EDS EP HOSPITAL OP PHCY SAFEWAY 6580 US HIGHWAY 93 S, WHITEFISH (406) EDS P EP WALGREENS 700 E 13TH ST, WHITEFISH (406) EDS EP WHITEFISH 1111 BAKER AVE, WHITEFISH (406) EDS EP DISCOUNT WHITEHALL WHITEHALL DRUG 203 W LEGION ST, WHITEHALL (406) EDS P EP WOLF POINT NE MT HEALTH TH AVE N, WOLF POINT (406) EDS P EP SERVICES WOLFPOINT 19

22 Mail Order Pharmacy CVS Caremark Mail Service Pharmacy Customer Care: TTY/TDD: 711 LA Limited access (i.e., pharmacy not available to all members) EDS Extended day supply available P Pharmacy offering preferred cost sharing EP Pharmacy supports electronic prescribing 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, ReadyFill at Mail. 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 25 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 calling us at TTY/TDD users should call 711. If you have used mail order services with your current plan before, or if you opt in now, our pharmacy will automatically fill and ship new prescriptions received directly from your doctors or other prescribers. You may opt out of automatic deliveries of new prescriptions at any time by contacting us. If you never had mail order delivery and/or decide to stop automatic fills of new prescriptions, we will contact you each time we get a new prescription from a provider, to see if you want the medication filled and shipped at that time. This will give you an opportunity to make sure that the correct drug (including strength, amount, and form) will be delivered, and, if necessary, allow you to cancel or delay the order before you are billed and it is shipped. Typically, you should expect to receive your prescription drugs within 10 calendar 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/TDD users should call 711. EDS P EP 20

23 Home Infusion Pharmacies MedicareBlue Rx only covers the cost of prescription drugs obtained from home infusion pharmacies. We do not cover other costs associated with the home infusion pharmacy services, such as nursing services and home infusion medical supplies. Please call Customer Service at , 8 a.m. to 8 p.m., daily, Central and Mountain times, for more information about home infusion pharmacy services. TTY users should call 711. LA Limited access (i.e., pharmacy not available to all members) P Pharmacy offering preferred cost sharing EDS Extended day supply available EP Pharmacy supports electronic prescribing BILLINGS WALGREENS INFUSION SERVICES BOZEMAN WALGREENS INFUSION SERVICES BUTTE WALGREENS INFUSION SERVICES GREAT FALLS SPECTRUMS HOME SOLUTIONS KALISPELL BIG SKY IV CARE MISSOULA PARTNERS SOLUTIONS 404 N 31ST ST STE 401, BILLINGS S FERGUSON AVE STE 1, BOZEMAN W PLATINUM ST STE D, BUTTE TH AVE S, GREAT FALLS FOUR MILE DR STE 3, KALISPELL PALMER ST STE B, MISSOULA (800) LA EDS EP (406) LA EDS EP (866) LA EDS EP (406) LA EDS (406) LA EDS (406) LA EDS EP 21

24 Long-Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under MedicareBlue Rx through the facility s long-term care pharmacy or another network long-term care pharmacy. Long-term care pharmacies can only provide up to a one-month supply. Please call Customer Service at , 8 a.m. to 8 p.m., daily, Central and Mountain times, for long-term care pharmacies in other areas or for more information about long-term care pharmacy services. TTY users should call 711. LA Limited access (i.e., pharmacy not available to all members) EDS Extended day supply available P Pharmacy offering preferred cost sharing EP Pharmacy supports electronic prescribing ANACONDA COMMUNITY HOSPITAL OF ANACONDA BIG SANDY BIG SANDY BIGFORK BIGFORK DRUG INC BILLINGS 401 W PENNSYLVANIA ST, ANACONDA JOHANNES AVE, BIG SANDY MT HIGHWAY 35, BIGFORK (406) LA EP (406) LA EP (406) LA EP ASPEN MEADOWS BILLINGS HLTH & REHABILITATION NCS HEALTHCARE OF MONTANA 3155 AVENUE C, BILLINGS CENTRAL AVE, BILLINGS ENTERPRISE AVE STE 1, BILLINGS LTC TH AVE N STE 110B, BILLINGS ST. JOHN'S LUTHERAN MINISTRIES, INC 3940 RIMROCK RD, BILLINGS (406) LA EP (406) LA EP (406) LA EP (406) LA EP (406) LA EP CHESTER CHESTER CHINOOK CHINOOK 30 MAIN STREET, CHESTER INDIANA ST, CHINOOK (406) LA EP (406) LA EP 22

25 Long-Term Care Pharmacies CIRCLE MCCONE COUNTY HEALTH CENTER COLUMBIA FALLS VA SATELLITE CONRAD OLSON'S DRUG VILLAGE DRUG DEER LODGE KEYSTONE DRUG ENNIS ENNIS FORSYTH YELLOWSTONE FORT BENTON 605 SULLIVAN AVE, CIRCLE VETERANS DRIVE BOX 250, COLUMBIA FALLS TH AVE SE, CONRAD S MAIN ST STE 2, CONRAD MAIN ST, DEER LODGE MAIN ST, ENNIS MAIN ST, FORSYTH (406) LA (406) LA (406) LA EP (406) LA EP (406) LA EP (406) LA EP (406) LA EP BENTON 1418 FRONT ST, FORT BENTON (406) LA EP GLASGOW 5TH AVENUE AND GIFT WESTERN DRUG OF GLASGOW GLENDIVE GLENDIVE MEDICAL CENTER 621 3RD ST S, GLASGOW ND AVE S, GLASGOW PROSPECT DR, GLENDIVE (406) LA EP (406) LA EP (406) LA 23

26 Long-Term Care Pharmacies GREAT FALLS BENEFIS AMBULATORY PHARMERICA HAMILTON BITTERROOT DRUG HARDIN PHARMCARE OF HARDIN INC HAVRE NORTHERN MONTANA HOSP HELENA GENEVA WOODS KALISPELL KALISPELL REGIONAL MED CENTER PHCY THE CLINICAL LEWISTOWN MONTANA MENTAL HEALTH NURSING CNTR LIVINGSTON KC WESTERN DRUG LONG TERM CARE PHCY TH AVE S STE 2, GREAT FALLS TH AVE S, GREAT FALLS W MAIN ST, HAMILTON N CENTER AVE, HARDIN TH ST, HAVRE WINNE AVE STE F, HELENA SUNNYVIEW LN, KALISPELL CONWAY DR, KALISPELL CASINO CREEK DR, LEWISTOWN W PARK ST STE B, LIVINGSTON (406) LA EP (406) LA EP (406) LA EP (406) LA EP (406) LA EP (406) LA EP (406) LA (406) LA EP (406) LA (406) LA EP 24

27 Long-Term Care Pharmacies MALTA VALLEY DRUG COMPANY MILES CITY HOLY ROSARY HEALTHCARE MISSOULA GRANITE PHCY HEALTH SOLUTIONS THE VILLAGE HEALTH CARE CENTER PHCY PLENTYWOOD PLENTYWOOD DRUG POLSON HEALTHCARE PLUS LTC POPLAR 131 SOUTH FIRST AVE E, MALTA WILSON ST, MILES CITY TH AVE STE 1, MISSOULA SOUTH AVE W, MISSOULA N MAIN ST, PLENTYWOOD TH AVE E, POLSON (406) LA EP (406) LA (406) LA EP (406) LA EP (406) LA EP (406) LA EP POPLAR 213 H ST EAST, POPLAR (406) LA EP RONAN FAMILY HEALTH R & R HEALTH CARE SOLUTIONS SCOBEY SERVICE DRUG HWY 93 S, RONAN US HIGHWAY 93 STE B, RONAN MAIN ST, SCOBEY (406) LA EP (406) LA EP (406) LA EP 25

28 Long-Term Care Pharmacies SHELBY NORTHTOWN DRUG 333 MAIN ST, SHELBY (406) LA EP LLC SIDNEY CLINIC TH AVE SW, SIDNEY (406) LA EP WHITE DRUG 402 E MAIN ST, SIDNEY (406) LA EP VICTOR NORTH RIDGE 2824 HWY 93 N STE B, VICTOR (406) LA EP HEALTHCARE RIDGEWAY 2824 HWY 93 NORTH, VICTOR (406) LA EP WARM SPRINGS MONTANA STATE 202 GARNET WAY, WARM SPRINGS (406) LA HOSPITAL WHITE SULPHUR SPRINGS CASTLE MOUNTAIN 25 E MAIN, WHITE SUIPHUR SPRING (406) LA EP DRUG

29 Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies Only Native Americans and Alaska Natives have access to Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies through MedicareBlue Rx s pharmacy network. Those other than Native Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances (e.g., emergencies). Please call Customer Service at , 8 a.m. to 8 p.m., daily, Central and Mountain times, for more information about I/T/U pharmacy services. TTY users should call 711. LA Limited access (i.e., pharmacy not available to all members) EDS Extended day supply available P Pharmacy offering preferred cost sharing EP Pharmacy supports electronic prescribing BOX ELDER ROCKY BOY HEALTH CENTER BROWNING BLACKFEET COMMUNITY HOSPITAL CROW AGENCY CROW INDIAN HOSPITAL HARLEM FT BELKNAP HEALTH CENTER PHCY HAYS HAYS INDIAN HEALTH CENTER HEART BUTTE HEART BUTTE LAME DEER LAME DEER HEALTH CENTER 535 CLINIC RD E, BOX ELDER HOSPITAL CIRCLE, BROWNING HWY & 1-90 INTERSECTION, CROW AGENCY GROS VENTRE AVE, HARLEM WHITE CROW ROAD, HAYS DISNEY, HEART BUTTE CHEYENNE AVE., LAME DEER (406) LA EDS (406) LA EDS (406) LA EDS EP (406) LA EDS EP (406) LA EDS (406) LA EDS (406) LA EDS EP 27

30 Indian Health Service/Tribal/Urban Indian Health Program (I/T/U) Pharmacies LODGE GRASS LODGE GRASS PABLO CONFED SALISH/ KOOTENAI TRIBES POPLAR HARDING AVE, LODGE GRASS HWY 93 N, PABLO (406) LA EDS EP (406) LA EDS EP POPLAR 107 H STREET E, POPLAR (406) LA EDS EP PRYOR PRYOR WOLF POINT WOLF POINT PRYOR GAP ROAD, PRYOR TH AVE. N., WOLF POINT (406) LA EDS (406) LA EDS EP 28

31 NOTICE OF RIGHTS NONDISCRIMINATION AND ACCESSIBILITY MedicareBlue SM Rx (PDP) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MedicareBlue Rx does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. MedicareBlue Rx: Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o 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: o Qualified interpreters o Information written in other languages If you need these services, and are currently enrolled with MedicareBlue Rx, call customer service at , daily, 8:00 a.m. to 8:00 p.m. Central and Mountain times (TTY: 711). If you need these services, but are not currently enrolled with MedicareBlue Rx, call our pre-enrollment call center at , daily, 8:00 a.m. to 8:00 p.m. Central and Mountain times (TTY: 711). If you believe that MedicareBlue Rx 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 in writing to: MedicareBlue Rx Compliance Officer 3400 Yankee Drive, R337 Eagan, MN You can file a grievance by mail. If you need help filing a grievance, the MedicareBlue Rx Compliance Officer is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, through one of the following methods: Electronically through the Office of Civil Rights Complaint Portal By Mail U.S. Department of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building

32 Washington, DC By Phone (TDD) Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: 711). Hmong: LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (TTY: 711). Amharic: ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (መስማት ለተሳናቸው: 711). ةیوغللا ةدع سملاا تامدخ نإف ةغللا ركذا ثدحتت تنك اذإ :ةظوحلم مقر Arabic: :مكبلاو مصلا فتاھ( 117 ). مقرب لصتا.ناجملاب كل رفاوتت Chinese: 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (TTY:711) Chinese Cantonese: 您對我們的健康或藥物保險可能存有疑問, 為此我們提供免費的翻譯服務 如需翻譯服務, 請致電 我們講中文的人員將樂意為您提供幫助 這是一項免費服務 Chinese Mandarin: 我们提供免费的翻译服务, 帮助您解答关于健康或药物保险的任何疑问 如果您需要此翻译服务, 请致电 我们的中文工作人员很乐意帮助您 这是一项免费服务 Cushite (Oromo): XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (TTY: 711). French: ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le (ATS : 711). French Creole: ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (TTY: 711). German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (TTY: 711). Hindi: ध य न द : य द आप ह द ब लत ह त आपक लए मफ त म भ ष सह यत स व ए उपलब ध ह (TTY: 711) पर क ल कर Italian: ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (TTY: 711).

33 Japanese: 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます (TTY: 711) まで お電話にてご連絡ください Karen: Korean: 주의: 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 (TTY: 711) 번으로전화해주십시오. Laotian: ໂປດຊາບ: ຖາວາ ທານເວ າພາສາ ລາວ, ການບລການຊວຍເຫ ອດານພາສາ, ໂດຍບເສຽ ຄ າ, ແມນມ ພ ອມໃຫ ທ ານ. ໂທຣ (TTY: 711). Mon-Khmer, Cambodian: របយ ត (TTY: 711) ប ស នជ អ កន យ យ ភ ស ខ រ, សវ ជ ន យ ផ កភ ស ដ យម នគ តឈ ល គ ឣ ចម នស រ ប ប រ អ ក ច រ ទ រស ព Polish: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (TTY: 711). Portugués: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (TTY: 711). Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (телетайп: 711). Serbo-Croatian (Serbian): OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite (TTY- Telefon za osobe sa oštećenim govorom ili sluhom: 711). Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (TTY: 711). Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (TTY: 711).

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36 This Pharmacy Directory was updated on 09/19/2016. For more recent information or other questions, please contact MedicareBlue Rx at: Individual members call , or for TTY users, 711 Members who purchase through an employer group call , or for TTY users, a.m. to 8 p.m., daily, Mountain Time Or visit: YourMedicareSolutions.com Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website YourMedicareSolutions.com. You may also call Customer Service for updated provider information. MedicareBlue Rx and Group MedicareBlue Rx are Medicareapproved Part D sponsors. Enrollment in MedicareBlue Rx depends on contract renewal and enrollment in Group MedicareBlue Rx depends on renewal of the plan sponsor s contract with Medicare. RAS1170R09 (10/16)