Choose from more than 3,819 network pharmacies!
Not only do you get generous benefits, but you can also choose from more than 3,819 network pharmacies. How easy is that? With Elderplan, you can save money on drugs and never have to travel far to fill your prescriptions.
That’s because Elderplan has contracts with pharmacies in Greater Metropolitan New York that equal or exceed Medicare’s requirements for pharmacy access in your area. To find out if one of our pharmacies is in your neighborhood, check out our pharmacy look-up tool. Elderplan offers national in-network prescription coverage. This means that you will pay the same amount for your prescription drugs if you get them at an in-network pharmacy outside of the plan’s service area (for instance, when you travel).
If one of our many pharmacies is just a little too far away, you can still have your prescriptions delivered to your doorstep with our mail-order pharmacy benefit. Plus, in some cases, mail-order prescriptions can save you even more money than going to the pharmacy yourself!
We have network pharmacies outside of the service area where you can get your drugs covered as a member of our plan. Generally, we only cover drugs filled at an out-of-network pharmacy in limited circumstances when a network pharmacy is not available. Below are some circumstances when we would cover prescriptions filled at an out-of-network pharmacy. Before you fill your prescription in these situations, call Member Services to see if there is a network pharmacy in your area where you can fill your prescription. If you do go to an out-of-network pharmacy for the reasons listed below, you may have to pay the full cost (rather than paying just your co-payment) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a claim form. You should submit a claim to us if you fill a prescription at an out-of-network pharmacy as any amount you pay will help you qualify for catastrophic coverage.
We will cover your prescriptions 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 urgently needed care. If you are traveling within the United States, but outside of the service area, and you become ill or lose or run out of your prescriptions. If you are unable to get 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 covered prescription drug that is not regularly stocked at an eligible network retail or mail-order pharmacy (these drugs include orphan drugs or other specialty pharmaceuticals). If you are getting a vaccine that is medically necessary but not covered by Medicare Part B and is administered by your doctor’s office.
In these situations, you will have to pay the full cost (rather than just a co-payment) when you fill your prescription. You can ask us to reimburse you for our share of the cost by submitting a paper claim form.
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 your paper claim form and your receipt to the following address:
P.O. Box 52000
Phoenix, AZ 85072-2000
Prescriptions delivered to you.
Never leave the house! For certain kinds of drugs, you can use the plan’s network mail-order services. Mail-order drugs are drugs that you take on a regular basis, for a chronic or long-term medical condition. To get order forms and information about filling your prescriptions by mail, please contact Member Services or visit the CVS/caremark Home Delivery Service website: English | Español.