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AmeriHealth® AdvantagePharmacy networkOur plans contract with PerformRx to manage Medicare Part D prescription benefits through a large, nationwide network. In order to receive benefits through your prescription plan, prescriptions must be filled at a PerformRx network pharmacy except under non-routine circumstances when it is not reasonable to use network pharmacies. PerformRx currently contracts with more than 11,500 pharmacy providers, including:
These pharmacies meet or exceed CMS (Centers for Medicare & Medicaid Services) requirements for pharmacy access in your area.
To confirm that a pharmacy is currently in our network, please call the Customer Service number printed on the back of your ID card, 8 a.m. to 8 p.m., seven days a week. If you go to a pharmacy outside of the networkWe will cover your prescription (for covered Part D drugs) at an out-of-network pharmacy if at least one of the following applies:
How to submit a paper claimIf 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 to the provider. When you return home, simply submit a claim form to us along with your receipt. You will be refunded the full amount minus any copays. Mail-order pharmacy serviceWhen you order prescription drugs through our network mail-order pharmacy service, you must order at least a 34-day supply, and no more than a 34-day supply of the drug. Generally, it takes the mail-order pharmacy 14 days to process your order and ship it to you. However, sometimes your mail-order may be delayed. If this happens, you may be able to receive a 10-day, temporary supply of a drug. Please have your local pharmacy call the PerformRx Pharmacy Help Desk at 1-800-684-5502, Monday through Sunday, 24 hours a day. You are not required to use mail-order prescription drug services to obtain an extended supply of
maintenance medications. Instead, you have the option of using another network retail pharmacy in our
network to obtain a supply of maintenance/mail-order medications. Some of these retail pharmacies To get order forms and information about filling your prescriptions by mail, call Customer Service at
1-888-567-9129 (TTY/TDD: 1-888-457-3002), 7 days a week, 8 a.m. to 8 p.m. Please note that you
must use our network mail-order service. Prescription drugs that you get through any other mail-order
services are not covered. If you travel outside the U.S.We cannot pay for any prescriptions that are filled by pharmacies outside the United States, even for a medical emergency. Please call Customer Service at the number printed on the back of your ID card, 8 a.m. to 8 p.m., seven days a week, for more information on paper claims or to request a form. Helpful linksPerformRx |
