Using an Out-of-Network Pharmacy

 

There may be times when you need to use an out-of-network pharmacy:

 

There’s no network pharmacy close or open 24 hours
 

You need a prescription drug that nearby network or mail-order pharmacies don’t often stock, like drugs for rare medical conditions.
 

Generally, we cover drugs filled at an out-of-network pharmacy only when you are not able to use a network pharmacy. To help you, we have network pharmacies outside of our service area where you can get your prescriptions filled as a member of our plan.  
 

You get a Part D prescription drug from an out-of-network provider pharmacy from:

  • An emergency room
  • A provider-based clinic
  • An ambulatory surgical center
  • An outpatient setting
 

An exception may be allowed to process a short-term/emergency fill (up to 30-day supply) at a retail pharmacy; the pharmacy may call Envision Help Desk for an override request. Envision Help Desk for Phone Number: 1-844-838-0706

 

Your plan coverage document (Evidence of Coverage) has more details about out-of-network pharmacies. If you may need another copy of your Evidence of Coverage, please contact TakeCare Customer Service at 1-877-484-2411 (TTY 711), Available 24 Hours a Day, 7 Days a Week.

 


 

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