AmeriHealth 65 Plus contracts with FutureScripts Secure to provide Medicare Part D prescription benefit management services and an extensive pharmacy network.
The network includes:
- national chain and independent retail pharmacies
- long term care and home infusion pharmacies
- mail order pharmacy services
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Program pharmacies
FutureScripts Secure will contract with more than 65,000 pharmacies effective January 1, 2007.
FutureScripts Secure has contracts with pharmacies that equal or exceed CMS requirements for Pharmacy access in your area.
In order to receive benefits through AmeriHealth 65 Plus, prescriptions must be filled at an AmeriHealth 65 network pharmacy. However, covered Part D drugs are available at out-of-network pharmacies in special circumstances including illness while traveling outside of the Plan's service area where there is no network pharmacy. You will need to pay the entire cost of the drug and then AmeriHealth 65 will reimburse you the full amount minus the applicable copayments.
Find a Pharmacy
Download a 2007 Pharmacy Directory - New Jersey (South)
This directory is for Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Mercer, Monmouth, Ocean, and Salem Counties.
Download a 2007 Pharmacy Directory - New Jersey (North)
This directory is for Bergen, Essex, Hudson, Hunterdon, Middlesex, Morris, Passaic, Somerset, Sussex, Union, and Warren Counties.
In order to receive benefits through your prescription plan, prescriptions must be filled at a network pharmacy. To confirm that a pharmacy is in our network, please call the Member Services Department
For AmeriHealth 65 Plus, call at 1-800-645-3965 (TTY/TDD 1-888-857-4816) 8:00 am to 8:00 pm seven days a week.
Out of Network Coverage
Covered Part D drugs are available at out-of-network pharmacies in special circumstances including illness while traveling outside of the Plan's service area where there is no network pharmacy. We will cover your prescription at an out-of-network pharmacy if at least one of the following applies:
- If the prescriptions are related to care for a medical emergency or urgent care.
- If you are unable to obtain a covered drug in a timely manner within our service area because there are no network pharmacies within a reasonable driving distance that provide 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).
- Some covered drugs that are administered in your doctor's office.
You will be required to pay the full cost and then submit for reimbursement. If you do go to an out-of-network pharmacy, this Plan will pay only for a 10-day supply of drugs.
We cannot pay for any prescriptions that are filled by pharmacies outside the United States, even for a medical emergency.
How to submit a paper claim
When you go to a network pharmacy, your claim is automatically submitted to us by the pharmacy. However, if you go to an out-of-network pharmacy for one of the reasons listed above, the pharmacy may not be able to submit the claim directly to us. When that happens, you will have to pay the full cost of your prescription. When you return home, simply submit a claim form and your receipt.
Please call Member Services for more information on paper claims or to request a form.
Mail Order Pharmacy Service
You can use our network mail-order pharmacy service to fill prescriptions for what we call "mail-order drugs." These are drugs that you take on a regular basis, for a chronic or long-term medical condition. Generally, it takes us 10-14 days to process your order and ship it to you. However, sometimes your mail order may be delayed. If we anticipate a delay in shipment of more than 10 days, for any reason, we will call you within 24 hours of receiving and logging the prescription. We will consult with you to help you decide whether to wait for the medication, cancel the mail order, or fill the prescription at a local pharmacy.
You are not required to use our mail-order services to get an extended supply of mail-order drugs. You can also get an extended supply through some retail network pharmacies.
If you have questions, call member services toll-free:
For AmeriHealth 65 Plus, call at 1-800-645-3965 (TTY/TDD 1-888-857-4816) 8:00 am to 8:00 pm seven days a week.
