FHCP Medicare Pharmacy network consists of:
Preferred Retail Pharmacies - A network pharmacy that offers covered drugs to members of our plan
at lower cost-sharing levels than at a network standard retail pharmacy
Contracted Standard Retail Pharmacies - A network pharmacy that offers covered drugs to members of our plan
at higher cost-sharing levels than at a network preferred retail pharmacy
Mail Order pharmacy,
Home Infusion pharmacies and
Long-term Care pharmacies.
You can use the FHCP Medicare’s mail order network. Generally the
drugs provided through FHCP’s Mail Order Pharmacy are drugs that
you take on regular basis, for a chronic or long-term medical condition.
These are the only drugs available through FHCP’s Mail Order Pharmacy
and are marked as “mail-order” drugs in our Drug List.
When you order prescription drugs by mail, you must order at least a 62-day
supply and no more than a 93-day supply of the drug.
To get order forms and information about filling your prescriptions by
FHCP’s Mail Order Pharmacy
386-676-7126 or 1-800-232-0216
Hours of operation: 8:30 a.m. - 5:30 p.m. local time, Monday through Friday
Hearing Impaired: 1-800-955-8770
Please note: You must use FHCP’s Mail Order Pharmacy. Prescription drugs that
you get through any other mail order pharmacy are not covered.
When can you use a pharmacy that is not in the plan’s network?
Your prescription may be covered in certain situations
Generally, we cover drugs filled at an out-of-network pharmacy
only when you are not able to use a network pharmacy. If you cannot use a network
pharmacy, here are the circumstances when we would cover prescriptions
filled at an out-of-network pharmacy:
If you are traveling within the United States and its territories and become
ill, lose or run out of your prescription drugs, we will cover prescriptions
that are filled at an out-of-network pharmacy. Coverage in this situation
will be for a
temporary 31-day supply of medication, or less if your prescription is for fewer days.
We will cover prescriptions that are filled at an out-of-network pharmacy
if the prescriptions are related to care for a medical emergency or urgent care.
We will cover your prescription at an out-of-network pharmacy if at least
one of the following applies: If you are unable to obtain a covered drug
in a timely manner within our service area because there is no network
pharmacy within a reasonable driving distance that provides 24-hour service.
If you are trying to fill a prescription drug that is not regularly stocked
at an accessible network retail pharmacy (including high-cost and unique drugs).
If you are getting a vaccine that is medically necessary but not covered
by Medicare Part B.
Please Note: If you purchase a drug at an out-of-network pharmacy, and one of the situations
explained above applies to you, you may be reimbursed at our plan’s
standard in-network pharmacy rate, not the full price that you paid for
the drug. Additionally, the difference in the plan’s reimbursement
amount and the total amount you paid for the drug will be included in
your total out-of-pocket costs.
When none of the situations explained above apply and you voluntarily pay
out-of-pocket for a drug, you will be responsible for paying the total
cash price of the drug, and you will not be reimbursed by our plan. The
amount you pay will not apply toward your total out-of-pocket costs. In
please check first with Member Services to see if there is a network pharmacy nearby. (Phone numbers for Member
Services are printed on the back cover of this booklet.) You may be required
to pay the difference between what you pay for the drug at the out-of-network
pharmacy and the cost that we would cover at an in-network pharmacy.
How do you ask for reimbursement from the plan?
If you must use an out-of-network pharmacy, you will generally have to
pay the full cost (rather than your normal share of the cost) at the time
you fill your prescription. You can ask us to reimburse you for our share
of the cost by submitting a paper claim to
FHCP Medicare’s pharmacy network includes limited lower-cost, preferred
pharmacies in Brevard, Flagler, Seminole, St. Johns and Volusia counties,
Florida. The lower costs advertised in our plan materials for these pharmacies
may not be available at the pharmacy you use. For up-to-date information
about our network pharmacies, including whether there are any lower-cost
preferred pharmacies in your area, please call 1-833-866-6559 (TTY user
call 1-800-955-8770) or consult the online pharmacy directory at
Florida Health Care Plans
Attn: Claims Department
P.O. Box 9910
Daytona Beach, FL 32120