Procare Rx (Prescription Drug Plan) to New Vendor

ProCare Rx (Prescription Drug Plan) to New Vendor

ProCare Rx is the company provider for ARUP Laboratories prescription drug plan. Your pharmacy plan under ProCare Rx includes:

·  24-hour, 365-day-a-year Customer Care Center

·  Non-Preferred national network of over 64,000 pharmacies.

·  Preferred Pharmacy Network

o  Current preferred pharmacy networkinclude Dan’s, Harmons, Wal-Mart & Sam’s, Smiths (Kroger), Fresh Market, Shopko, Kmart and Fred Myer. Other small independent pharmacy included are Apothecary West and Burch Family Pharmacy.

·  Home Delivery for your medications from the ProCare Rx mail order and specialty pharmacy, ProCare PharmacyCare (PPC)

* To receive the in-network level of benefits, you must use a pharmacy in the Align network.

Getting Prescriptions from a Participating Pharmacy

Please show your new prescription ID card to your pharmacist each time you get a prescription filled. To locate pharmacies near you that are in ProCare Rx’s network, either call the Customer Care Center for assistance, or use our Pharmacy Locator at www.procarerx.com.

If for any reason you need to submit a claim to ProCare Rx for reimbursement, please send to:

ProCare Rx

1267 Professional Parkway

Gainesville, GA 30507

How to Use Mail Order

To take advantage of added savings and the convenience of home delivery through the mail order program, just complete the mail order brochure that was sent to you with your new ID cards. The brochure is only necessary for your first order, and all dependents may be listed on the same page of the brochure. Obtain mail order prescriptions from your doctor, and clearly write your name, date of birth, and member ID number on the back. Mail your completed brochure and prescriptions to ProCare PharmacyCare (PPC) at the address shown below. Over 99% of all prescriptions are sent out within 24 hours of receipt.

24-Hour Customer Care Center

If you have questions about your prescription benefit plan, please call ProCare Rx at 855-828-1484.

Mail Order Address:

When mailing information to the mail order pharmacy, please send to:

ProCare PharmacyCare

3891 Commerce Parkway

Miramar, FL 33025

PRESCRIPTION DRUGS
Pharmacy Processing information:
BIN: 009430
PCN: NO PCN
Group: ALRX9999
24 Customer Service line: 855-828-1484 / Retail Copays / 30-Day Supply at Preferred Pharmacy / 30-Day Supply at Non-Preferred Pharmacy / Specialty at Retail
Generic / $5 / $15 / 35% up to $150 maximum
Brand / $30 / $50
Brand (Non-Preferred) / 35% up to $150 / 35% up to $145
ProCare PharmacyCare (PPC)
Mail Order Program / Mail Order Copays / 90-Day Supply at PPC / Specialty Drugs at PPC
Generic / $45 / %35 up to $450
Brand / $150
Brand (Non-Preferred) / 35% up to $450
Receive up to a 90-day supply of maintenance drugs only with a mail order copay.

What Drugs Are Covered?

The plan has an open formulary that generally covers all drugs prescribed by a physician that require a prescription either by federal or state law, including:

ü  All legend drugs are covered unless specified otherwise.

ü  Compound Medications (Excluding certain compounds) are covered up to $150, member pays out of pocket. (No Prior Authorization).

ü  Prior Authorization for athcar gel – only allowed for infantile spas.

ü  Prior Authorization for Intuniv – requires a trial of guanfacine first.

ü  DAW 1 penalty applies, excluding SYNTHROID, TRANSPLANT and ANTI-SEIZURE drugs.