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.