Moda Health Plan, Inc.

Transcription

1 Moda Health Plan, Inc Part D Directory For more recent information or other questions, please contact Moda Health Plan, Inc. Customer Service at , or, for TTY users, 711, from 7 a.m. to 8 p.m., Pacific Time seven days a week, or visit modahealth.com/medicare. Y0115_RXDIR18A_NM

2 Next year, you can get plan documents delivered to you online Online documents give you easy access to all your Medicare information. The Centers for Medicare and Medicaid Services (CMS) require that we send you important plan documents every year. These documents contain information specific to your Moda Health plan: > > Combined Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) > > Comprehensive formulary (if applicable) That s a lot of paper to clutter your home. Luckily, all of these documents are available electronically through your mymoda account. To receive an from Moda Health when new materials are available, simply log in to your mymoda account by visiting The mymoda log in is on the right side of your screen. You can also create an account on this page. Once logged in, select the Account tab. Next, click on Change account settings. From here, you can update your and make your electronic delivery preference. Once you request electronic delivery, you will no longer receive these documents in the mail. Questions? Call us at Cut down on more paper sign up for ebill today! Now you can pay your premium online with ebill. Using ebill, you can view invoices online and set up your preferred payment methods (debit card, checking or savings) and set a recurring payment using our AutoPay feature. To access ebill, log in to mymoda and click on the ebill tab (7/17) MDCR-1432 Health plans in Oregon and Alaska provided by Moda Health Plan, Inc. Dental plans in Oregon provided by Oregon Dental Service, dba Delta Dental Plan of Oregon. Dental plans in Alaska provided by Delta Dental of Alaska.

3 Moda Health nondiscrimination notice Moda, Inc. complies with applicable federal civil rights laws. We do not discriminate on the basis of race, color, national origin, age, disability or sex. Moda provides free, timely aids and services to people with disabilities to help them communicate with us effectively. These accommodations include sign language interpreters and written information in other formats. If your primary language is not English, Moda also provides free, timely interpretation services and/or materials written in other languages. If you need any of the services listed above, contact: Medicare Customer Service, (TDD/TTY 711) If you believe that Moda has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a written grievance by mailing or faxing it to: Moda, Inc. Attention: Appeal Unit 601 SW Second Ave. Portland, OR Fax: If you need assistance filing a grievance, please call Customer Service. You can also file a civil rights complaint with the U.S. Department of Health and Human Services Office for Civil Rights at ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone to: U.S. Department of Health and Human Services 200 Independence Ave. SW, Room 509F HHH Building, Washington, DC , (TDD). Office for Civil Rights complaint forms are available at hhs.gov/ocr/office/file/index.html. Moda s efforts to assure nondiscrimination are coordinated by: Tom Bikales, VP Legal Affairs 601 SW Second Ave. Portland, OR compliance@modahealth.com Health plans in Oregon and Alaska provided by Moda Health Plan, Inc. Dental plans in Oregon provided by Oregon Dental Service, dba Delta Dental Plan of Oregon. Dental plans in Alaska provided by Delta Dental of Alaska (8/16)

4 ATENCIÓN: Si habla español, hay disponibles servicios de ayuda con el idioma sin costo alguno para usted. Llame al (TTY: 711). 注意 : 如果您說中文, 可得到免費語言幫助服務 請致電 ( 聾啞人專用 :711) CHÚ Ý: Nếu bạn nói tiếng Việt, có dịch vụ hổ trợ ngôn ngữ miễn phí cho bạn. Gọi (TTY:711) 주의 : 한국어로무료언어지원서비스를이용하시려면다음연락처로연락해주시기바랍니다. 전화 (TTY: 711) PAUNAWA: Kung nagsasalita ka ng Tagalog, ang mga serbisyong tulong sa wika, ay walang bayad, at magagamit mo. Tumawag sa numerong (TTY: 711) ВНИМАНИЕ! Если Вы говорите по-русски, воспользуйтесь бесплатной языковой поддержкой. Позвоните по тел (текстовый телефон: 711). تنبيه: إذا كنت تتحدث العربية فهناك خدمات مساعدة لغوية متاحة لك مجان ا. اتصل برقم )الهاتف النصي: 711( ATANSYON: Si ou pale Kreyòl Ayisyen, nou ofri sèvis gratis pou ede w nan lang ou pale a. Rele nan (moun ki itilize sistèm TTY rele : 711) ATTENTION : si vous êtes locuteurs francophones, le service d assistance linguistique gratuit est disponible. Appelez au (TTY : 711) UWAGA: Dla osób mówiących po polsku dostępna jest bezpłatna pomoc językowa. Zadzwoń: (obsługa TTY: 711) ATENÇÃO: Caso fale português, estão disponíveis serviços gratuitos de ajuda linguística. Telefone para (TERMINAL: 711) ATTENZIONE: Se parla italiano, sono disponibili per lei servizi gratuiti di assistenza linguistica. Chiamare il numero (TTY: 711) 注意 : 日本語をご希望の方には 日本語サービスを無料で提供しております (TTY テレタイプライターをご利用の方は 711) までお電話ください Achtung: Falls Sie Deutsch sprechen, stehen Ihnen kostenlos Sprachassistenzdienste zur Verfügung. Rufen sie (TTY: 711) توجه: در صورتی که به فارسی صحبت می کنید خدمات ترجمه به صورت رایگان برای شما موجود است. با 711( )TTY: تماس بگیرید. УВАГА! Якщо ви говорите українською, для вас доступні безкоштовні консультації рідною мовою. Зателефонуйте (TTY: 711) ATENȚIE: Dacă vorbiți limba română, vă punem la dispoziție serviciul de asistență lingvistică în mod gratuit. Sunați la (TTY 711) THOV CEEB TOOM: Yog hais tias koj hais lus Hmoob, muaj cov kev pab cuam txhais lus, pub dawb rau koj. Hu rau (TTY: 711) โปรดทราบ: หากค ณพ ดภาษาไทย ค ณ สามารถใช บร การช วยเหล อด านภาษาได ฟร โทร (TTY: 711) ត រ វចងច ប អ នកន យ យភ ស ខ ម រ ហ យត រ វ ក រស វ កម មជ ន យផ ន កភ ស ដ យឥតគ តថ ល គ ម នផ ដល ជ នល កអ នក ស មទ រស ព ទទ ក ន ល ខ (TTY: 711) HUBACHIISA: Yoo afaan Kshtik kan dubbattan ta e tajaajiloonni gargaarsaa isiniif jira (TTY:711) tiin bilbilaa.

5 Moda Health PPORX (PPO) Moda Health HMO PERS Moda Health Rx (PDP) PERS Moda Health PPORX (PPO) 2018 Directory This pharmacy directory was updated on September 1, For more recent information or other questions, please contact Moda Health Plan, Inc. Customer Service at , or, for TTY users, 711, from 7 a.m. to 8 p.m. Pacific Time seven days a week, from October 1 to February 14 (after February 15, your call will be handled by our automated phone system Saturdays, Sundays and holidays), or visit Changes to our pharmacy network may occur during the benefit year. An updated Directory is located on our website at You may also call Customer Service for updated provider information. This information is available for free in other languages. Please contact our Customer Service number at for additional information. (TTY users should call 711.) Customer Service hours are from 7 a.m. to 8 p.m., Pacific Time, seven days a week. Esta información está disponible en otros idiomas, sin costo. Por favor comuníquese al departamento de servicios a los miembros al Usuarios de TTY (teléfono de texto), llamen al 711. El departamento de servicios a los miembros está disponible de 7 a.m. a 8p.m., hora oficial del Pacífico, los siete días de la semana. Moda Health Plan, Inc. is a PPO, HMO and a stand-alone prescription drug plan with a Medicare contract. Enrollment in Moda Health Plan, Inc. depends on contract renewal. The pharmacy network may change at any time. You will receive notice when necessary. Y0115_RXDIR18A_NM 1

6 Introduction This booklet provides a list of Moda Health Plan, Inc. s network pharmacies. To get a complete description of your prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverage and Moda Health Plan, Inc. s formulary. We call the pharmacies on this list our network pharmacies because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under Moda Health Plan, Inc. only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at nonnetwork pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This list is current as of September 1, For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can get prescription drugs shipped to your home through our network mail order delivery program. For more information, please contact us or see the mail order section of this pharmacy directory. This directory is for the states of Oregon and Washington which includes the area in which you live. However, we cover a larger service area, and there are more pharmacies where your prescriptions may be covered by our Plan. For information on more pharmacies in our network not listed in this directory please contact our Customer Service number at (TTY users call 711) from 7 a.m. to 8 p.m., Pacific Time, seven days a week from October 1 through February 14 (after February 15 your call will be handled by our automated phone systems Saturdays, Sundays and holidays). If you have questions about any of the above, please see the first and last cover pages of this directory for information on how to contact us. 2

7 Moda Health s Network Pharmacies Retail Pharmacies, including Chain Pharmacies... 4 Chain Pharmacies... 4 Oregon... 4 Washington Mail Order Pharmacies Home Infusion Pharmacies Oregon Washington Long-Term Care Pharmacies Oregon Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies Oregon Washington Specialty Pharmacies Oregon Washington

8 Retail Pharmacies, including Chain Pharmacies Chain pharmacies are listed first in this section. Due to the large number of locations, addresses are not listed for chain pharmacies. To find information about locations near your home, call the toll free customer service number or visit the website that is listed under the name of each pharmacy. TTY users call 711. All other retail pharmacies are listed by state, then alphabetically by city. Additionally, the address, phone number and special services (if applicable) are listed for each retail pharmacy Chain Pharmacies Bartell Drugs (877) Bi-Mart (800) Costco (800) CVS (800) Fred Meyer (800) Haggen (800) QFC (800) Rite Aid (800) Safeway (877) Savon (877) es.com Shopko (800) Walgreens (800) Wal-Mart (800) Oregon Albany Elm Street th Ave SW Albany, OR (541) Geary Street Clinic 1700 SE Geary St Albany, OR (541) Medicap 1333 Clay Street SE Albany, OR (541) ,, Ashland Ashland Drug 53 North Second Street Ashland, OR (541) , Astoria Columbia Memorial Hospital Outpatient 2120 Exchange St Astoria, OR (503) , Paramount Drug 1319 Commercial St Astoria, OR (503) Bandon Bandon Community 1010 SE First Bandon, OR (541) , 4

9 Retail Pharmacies, including Chain Pharmacies Banks Banks NW Main St Banks, OR (503) , Beaverton Beaverton SW Canyon Rd Beaverton, OR (503) ,, OHSU Knight Cancer Institute-Beaverton Hematology Oncology SW Greystone Ct Beaverton, OR (971) Bend Community 2500 NE Neff Rd Bend, OR (541) Doc 1340 NW Wall St Bend, OR (541) Rose 1247 NE Medical Center Dr Bend, OR (541) ,, Westside 359 SW Century Dr Bend, OR (541) ,, Brownsville Brownsville 411 N Main Brownsville, OR (541) Canby Daves Prescription Shop 911 SW 4th Ave Canby, OR (503) Parsons Canby 294 NW 2nd Ave Canby, OR (503) Canyonville Gordon's 314 Main St Canyonville, OR (541) Cave Junction Caves 333 S Redwood Hwy Cave Junction, OR (541) Clatskanie Ricks Hi School 401 W Columbia River Hwy Clatskanie, OR (503) Condon Murrays Condon 225 South Main Condon, OR (541) , Corvallis Health Services 530 NW 27th St Corvallis, OR (541) Rice s 910 NW Kings Blvd Corvallis, OR (541) Samaritan 3521 NW Samaritan Dr Corvallis, OR (541) The Corvallis Clinic 3680 NW Samaritan Dr Corvallis, OR (541) Dallas Dallas Pill Box 625 SE Miller Ave Dallas, OR (503) ,, Enterprise Olive Branch 306 W North St Enterprise, OR (541)

10 Retail Pharmacies, including Chain Pharmacies Estacada Hi School 207 S Broadway Estacada, OR (503) Eugene Broadway Apothecary 1515 Oak St Eugene, OR (541) Hirons Drug 185 E 18th Ave Eugene, OR (541) Hirons Drug 1950 Franklin Blvd Eugene, OR (541) River Road Healthmart 884 River Road Eugene, OR (541) , Florence Florence 2935 Hwy 101 Florence, OR (541) , Gold Beach Corner Drug Ellensburg Ave Gold Beach, OR (541) Gold Hill Gold Hill 808 2nd Ave Gold Hill, OR (541) Grants Pass Asante Three Rivers 500 SW Ramsey Ave Grants Pass, OR (541) Grants Pass 414 SW 6th St Grants Pass, OR (541) , Trinity Valley 2001 Foothill Blvd Grants Pass, OR (541) Gresham Legacy Mount Hood Medical Center SE Stark St Gresham, OR (503) Harrisburg Harrisburg 230 N 3rd St Harrisburg, OR (541) , Heppner Murray Drug 217 N Main St Heppner, OR (541) Hermiston Hermiston Drug 114 Main St Hermiston, OR (541) , Hillsboro Hillsboro 243 E Main Hillsboro, OR (503) Providence Tanasbourne NW Cornell Rd Hillsboro, OR (503) The Medicine Shoppe 333 SE 7th Ave Hillsboro, OR (503) Hood River Providence Hood River th St Hood River, OR (541) Independence Hi School 1357 Monmouth Ave Independence, OR (503)

11 Retail Pharmacies, including Chain Pharmacies John Day Lens Drug 120 E Main St John Day, OR (541) , Klamath Falls Sky Lakes Outpatient 2865 Daggett Ave Klamath Falls, OR (541) La Pine Drug Mart Huntington Rd La Pine, OR (541) , Lakeview Howards Drugs 101 North F Street Lakeview, OR (541) Lebanon Lebanon Pill Box 185 Main St Lebanon, OR (541) ,, Samaritan Lebanon Community 675 N 5th St Lebanon, OR (541) Lincoln City Samaritan North Lincoln Hospital 3043 NE 28th St Lincoln City, OR (541) Madras Hometown Drugs 65 NE Oak St Madras, OR (541) ,, McMinnville Mac Prescription Shop 225 NE 3rd Street McMinnville, OR (503) Mac Prescription Shop at PMC 2435 NE Cumulus Ave McMinnville, OR (503) Medford Asante RRMC 2825 E Barnett Rd Medford, OR (541) Black Oak 2924 Siskiyou Blvd Medford, OR (541) , Lone Pine Drug 3528 Lone Pine Rd Medford, OR (541) , West Main Drug 2355 West Main St Medford, OR (541) Mill City Mill City 218 SW Broadway Mill City, OR (503) Molalla Cutters Hi School 103 Robbins St Molalla, OR (503) , Mt Angel Mt Angel Drug 105 N Main St Mt Angel, OR (503) Myrtle Point Semperts Drug 735 Spruce St Myrtle Point, OR (541)

12 Retail Pharmacies, including Chain Pharmacies Newberg Center 502 Villa Rd Newberg, OR (503) ,, Newport Samaritan Pacific Comm Hospital 930 SW Abbey St Newport, OR (541) North Bend Waterfall Community 1890 Waite St North Bend, OR (541) , Nyssa Malheur Drug 424 Main St Nyssa, OR (541) , Oakridge Postal Hwy 58 Oakridge, OR (541) Philomath Philomath Family 1640 Main St Philomath, OR (541) , 7901 SE Powell Blvd Portland, OR (503) , Apothecary at Good Samaritan 1040 NW 22nd Ave Portland, OR (503) Apothecary at Emanuel 501 N Graham St Portland, OR (503) Bowmans Hillsdale 6256 SW Capitol Hwy Portland, OR (503) , Brooklyn 3131 SE Milwaukie Ave Portland, OR (503) Central Drug 538 SW 4th Ave Portland, OR (503) Columbia 8122 SE Tibbetts Street Portland, OR (503) Fairleys Healthcare 7206 NE Sandy Blvd Portland, OR (503) Gateway Medical 1125 NE 99th Ave Portland, OR (503) , Lloyd Center 438 East Burnside St Portland, OR (503) , North Portland Clinic 9000 N Lombard St Portland, OR (503) OHSU Casey Eye Institute 3375 SW Terwilliger Blvd Portland, OR (503) OHSU Doernbecher Childrens Hospital 3181 SW Sam Jackson Park Portland, OR (503)

13 Retail Pharmacies, including Chain Pharmacies OHSU Gabriel Park 4411 SW Vermont Ave Portland, OR (503) OHSU Outpatient 3181 SW Sam Jackson Park Portland, OR (503) Paulsen's 4246 NE Sandy Blvd Portland, OR (503) Providence Plaza 5050 NE Hoyt Portland, OR (503) Stroheckers 1286 SE Holgate Blvd Portland, OR (503) , Prineville Clinic 198 NE Combs Flat Rd Prineville, OR (541) Redmond Community 1253 N Canal Blvd Redmond, OR (541) Reedsport Lower Umpqua Hospital 600 Ranch Rd Reedsport, OR (541) Reedsport 1409 Hwy 101 Reedsport, OR (541) Rogue River Rogue River 506 E Main Rogue River, OR (541) Roseburg Harvard Avenue Drugs and Health Mart 1175 W Harvard Ave Roseburg, OR (541) , Hometown Drugs 1813 W Harvard Ave Roseburg, OR (541) , Kmart 2757 NW Stewart Pkwy Roseburg, OR (541) Salem Alore 990 Commercial St SE Salem, OR (877) Oak Tree 2940 Commercial St SE Salem, OR (503) , Physicians Building 1234 Commerical St SE Salem, OR (503) Quisenberry Pharmacies 150 Liberty St SE Salem, OR (503) Salem Health Retail 890 Oak St SE Salem, OR (503) Scappoose Hi School SW Chinook Plaza Scappoose, OR (503) , Seaside Providence Seaside 725 S Wahanna Rd Seaside, OR (503) Shady Cove Shady Cove Hwy 62 Shady Cove, OR (541)

14 Retail Pharmacies, including Chain Pharmacies Sheridan Sheridan 103 E Main St Sheridan, OR (503) Silverton Hi School 406 McClaine St Silverton, OR (503) , Silverton Pill Box 302 N First St Silverton, OR (503) ,, Sisters Sisters Drug and Gift 211 E Cascade Sisters, OR (541) Stayton Stayton 102 Martin Dr Stayton, OR (503) , Sutherlin Sutherlin Drug 113 Central Ave E Sutherlin, OR (541) , Sweet Home Economy Drugs 621 Main St Sweet Home, OR (541) , Talent Medicap 205 N Pacific Highway Talent, OR (541) ,, The Dalles Kmart 2640 West 6th Street The Dalles, OR (541) , Mid-Columbia Medical Center 1700 E 19th St The Dalles, OR (541) Tillamook Tillamook 915 Main Ave Tillamook, OR (503) Toledo Mikes 722 W Highway 20 Toledo, OR (541) Tualatin Meridian Park Medical Center SW 65th Ave Tualatin, OR (503) Tualatin SW Martinazzi Ave Tualatin, OR (503) , Umatilla Carlsons Umatilla Drug 821 6th St Umatilla, OR (541) Union Union Drug Company 105 N Main Union, OR (541) , Vale Malheur Drug 198 A St W Vale, OR (541) Veneta Hi School Highway 126 Veneta, OR (541)

15 Retail Pharmacies, including Chain Pharmacies Waldport Hi School 110 SW Hwy 101 Waldport, OR (541) , West Linn Hi School 5639 NE Hood St West Linn, OR (503) Wheeler Rinehart 230 Rowe Rd Wheeler, OR (503) White City Cascade 7591 Crater Lake Hwy White City, OR (541) ,, Winston Valley Drugs 157 NW Douglas Blvd Winston, OR (541) , Woodburn Woodburn Health Center 1475 Mount Hood Ave Woodburn, OR (971) Washington Aberdeen Aberdeen Health Mart 1812 Sumner Ave Aberdeen, WA (360) , City Center Drug 108 E Wishkah St Aberdeen, WA (360) , Swansons Owl 117 N Boone St Aberdeen, WA (360) Airway Heights Yokes W Sunset Hwy Airway Heights, WA (509) Anacortes Family th St Anacortes, WA (360) , Arlington Arlington 540 N West Ave Arlington, WA (360) , Auburn Healthpoint Auburn North 923 Auburn Way N Auburn, WA (877) Healthpoint Auburn 126 Auburn Ave Auburn, WA (877) Sams 1101 Supermall Way SW Auburn, WA (253) Bellevue Cordant th Ave NE Bellevue, WA (425) Lakemont 4935 Lakemont Blvd SE Bellevue, WA (425) , Plus th Ave NE Bellevue, WA (425)

16 Retail Pharmacies, including Chain Pharmacies Bellingham Hoagland 2330 Yew St Bellingham, WA (360) ,, Hoagland 1414 Meador Ave Bellingham, WA (360) , Rx Mart 300 E Sunset Drive Bellingham, WA (360) , Benton City Logar 516 9th St Benton City, WA (509) Bonney Lake Rxpress State Route 410 E Bonney Lake, WA (253) ,, Bothell Healthpoint Bothell Beardslee Blvd Bothell, WA (877) Pacific Medical Centers - Canyon Park th St SE Bothell, WA (425) Bremerton Apothecary Shoppe 2500 Cherry Ave Bremerton, WA (360) Brewster Brewster Health Mart Drug 811 State Hwy 97 Brewster, WA (509) Buckley Chucks United Drugs 787 Main St Buckley, WA (360) Camano Island Marks Camano 370 NE Camano Dr Camano Island, WA (360) Cashmere Doane's 119 Cottage Ave Cashmere, WA (509) Castle Rock Castle Rock 117 1st SW Castle Rock, WA (360) Cathlamet Cathlamet 74 Main St Cathlamet, WA (360) Centralia Centralia 417 S Tower Ave Centralia, WA (360) , Providence Centralia Hospital Retail 914 S Scheuber Rd Centralia, WA (360) Chehalis Kmart 1201 Northwest Louisiana Chehalis, WA (360) Chelan Lake Chelan 223 E Johnson Ave Chelan, WA (509)

17 Retail Pharmacies, including Chain Pharmacies Cheney Owl 120 F St Cheney, WA (509) Chewelah Akers United Drug 406 N Park St Chewelah, WA (509) Valley Drug 102 E Main Ave Chewelah, WA (509) Clarkston Owl Tri-State 1275 Highland Ave Clarkston, WA (509) ,, Wasem's 800 6th St Clarkston, WA (509) , Cle Elum Cavallini 106 E 1st St Cle Elum, WA (509) Cle Elum Drug 219 E 1st St Cle Elum, WA (509) Clinton Island Drug State Route 525 Clinton, WA (360) , Colfax Tick Klock Drugs 109 S Main St Colfax, WA (509) , Colville Super N Highway Colville, WA (509) Darrington Darrington 1200 Seeman St Darrington, WA (360) , Davenport Davenport Good Neighbor 525 Morgan St Davenport, WA (509) ,, Lincoln County 621 Morgan St Davenport, WA (509) ,, Dayton Elk Drug 176 E Main St Dayton, WA (509) Deer Park Chas North County 401 S Main St Deer Park, WA (509) The Medicine Shoppe 11 E H Street Deer Park, WA (509) , Yokes 810 S Main St Deer Park, WA (509) Des Moines Des Moines 627 S 227th St Des Moines, WA (206) Dupont Dupont 1545 Wilmington Dr Dupont, WA (253)

18 Retail Pharmacies, including Chain Pharmacies Duvall Duvall Family Drugs Main St NE Duvall, WA (425) , Eastsound Rays 68 N Beach Rd Eastsound, WA (360) Eatonville Kirks 104 Mashell Ave Eatonville, WA (360) , Edmonds Edmonds th St SW Edmonds, WA (425) , Family th St SW Edmonds, WA (425) Highland Hwy 99 Edmonds, WA (425) Paktia 315 5th Ave S Edmonds, WA (425) Ellensburg Downtown Health Mart 414 N Pearl St Ellensburg, WA (509) , Super E Mountain View Ave Ellensburg, WA (509) Elma Elma 221 W Main St Elma, WA (360) Enumclaw Jims 3021 Griffin Ave Enumclaw, WA (360) , Everett Providence Medical Center 1321 Colby Ave Everett, WA (425) Sevan 620 SE Everett Mall Way Everett, WA (425) Everson Valley Drug 208 E Main St Everson, WA (360) , Fairfield Owl 208 E Main St Fairfield, WA (509) Federal Way Franciscan th Ave S Federal Way, WA (253) Highland Pacific Hwy S Federal Way, WA (253) Onuri 1014 S 320th St Federal Way, WA (253) , Fircrest Fircrest 1107 Regents Blvd Fircrest, WA (253) , 14

19 Retail Pharmacies, including Chain Pharmacies Forks Chinook 11 S Forks Ave Forks, WA (360) Friday Harbor Friday Harbor Drug 210 Spring St W Friday Harbor, WA (360) Gig Harbor Franciscan Canterwood Blvd NW Gig Harbor, WA (253) Olympic 4700 Pt Fosdick Dr NW Gig Harbor, WA (253) ,, Purdy Cost Less Prescriptions nd Ave NW Gig Harbor, WA (253) Granite Falls Pharm-A-Save 207 E Stanley St Granite Falls, WA (360) , Hoquiam Crown Drug 2544 Simpson Ave Hoquiam, WA (360) Harbor Drug 316 8th St Hoquiam, WA (360) , Ilwaco Ilwaco 101 First Ave South Ilwaco, WA (360) Issaquah Medical Center 450 NW Gilman Blvd Issaquah, WA (425) , Kalama Godfreys 270 N 1st St Kalama, WA (360) Kelso LJs Furness Drug 114 S Pacific Ave Kelso, WA (360) , Kenmore Ostroms Drug & Gift 6414 NE Bothell Way Kenmore, WA (425) , Kennewick Reliance 133 N Ely St Kennewick, WA (509) ,, Reliant Rx 4123 W 24th Ave Kennewick, WA (509) , at Trios Southridge 3730 Plaza Way Kennewick, WA (509) Yokes 1410 W 27th Ave Kennewick, WA (509) Kent Healthpoint Kent 403 E Meeker St Kent, WA (877) United Care E Valley Hwy Kent, WA (425) Kettle Falls Kettle Falls 280 W Third Ave Kettle Falls, WA (509)

20 Retail Pharmacies, including Chain Pharmacies Kirkland Evergreen Professional Center NE 130th Lane Kirkland, WA (425) Pacific Medical Centers Totem Lake Blvd NE Kirkland, WA (425) La Conner La Conner Drug 708 E Morris St La Conner, WA (360) , Lacey Hawks Prairie Health Mart 2539 Marvin Rd NE Lacey, WA (360) ,, Puget Services 1751 Circle Ln SE Lacey, WA (360) Lakewood Franciscan Bridgeport Way SW Lakewood, WA (253) Good 8741 South Tacoma Way Lakewood, WA (253) International Bridgeport Way SW Lakewood, WA (253) Lakewood 8720 South Tacoma Way Lakewood, WA (253) Leavenworth Village 815 Front St Leavenworth, WA (509) Liberty Lake Yokes 1233 N Liberty Lake Rd Liberty Lake, WA (501) Long Beach Long Beach 101 Bolstad Ave Long Beach, WA (360) Longview Peacehealth St John Medical Center 1615 Delaware St Longview, WA (360) Lopez Island Lopez Island 352 Lopez Rd Lopez Island, WA (360) Lynden Fairway Drug 1758 Front St Lynden, WA (360) , Lynnwood Bethel Hwy 99 Lynnwood, WA (425) Care th St SW Lynnwood, WA (425) , Marysville Hilton 220 State Ave Marysville, WA (360) , 16

21 Retail Pharmacies, including Chain Pharmacies McCleary McCleary Healthmart 115 W Simpson Ave McCleary, WA (360) , Mead Yokes N Market St Mead, WA (509) Medical Lake Owl 123 E Lake St Medical Lake, WA (509) Monroe Pharm-A-Save th St SE Monroe, WA (360) , Providence N Kelsey Street Monroe, WA (360) , Montesano Valu Drug 201 Pioneer Ave E Montesano, WA (360) , Morton Colton 377 S 2nd St Morton, WA (360) Moses Lake Laketown 1550 S Pioneer Way Moses Lake, WA (509) Southgate 2709 W Broadway Ave Moses Lake, WA (509) Mount Vernon Hilltop 1223 E Division St Mount Vernon, WA (360) , Skagit Regional Clinics Mount Vernon 1410 E Kincaid St Mount Vernon, WA (360) Skagit Regional Clinics Riverbend 2320 Freeway Dr Mount Vernon, WA (360) Newport Seebers 336 S Washington Ave Newport, WA (509) , Nine Mile Falls Lake Spokane 5919 F Hwy 291 Nine Mile Falls, WA (509) Normandy Park Access st Ave S Normandy Park, WA (206) , Oak Harbor Island Drug State Route 20 Oak Harbor, WA (360) ,, Saar's Marketplace State Route 20 Oak Harbor, WA (360) Ocean Park Ocean Park 1501 Bay Ave Ocean Park, WA (360)

22 Retail Pharmacies, including Chain Pharmacies Ocean Shores Ocean Shores 172 W Chance a La Mer NW Ocean Shores, WA (360) Odessa Odessa Drug 19 W 1st Ave Odessa, WA (509) Okanogan Okanogan Valley 236 N 2nd Ave Okanogan, WA (509) Olympia Providence St Peter Hospital 413 Lilly Rd NE Olympia, WA (360) Ralphs Thriftway th Ave E Olympia, WA (360) , Samy's Drug Store 3525 Ensign Rd NE Olympia, WA (360) , West Olympia 400 Yauger Way SW Olympia, WA (253) ,, Omak Omak Health Station 617 Benton St Omak, WA (509) Omak 903 Engh Rd Omak, WA (509) Orting Copes 134 Washington Ave S Orting, WA (360) Pasco Fiesta 115 S 10th Ave Pasco, WA (509) , Lourdes 7425 Wrigley Dr Pasco, WA (509) The Medicine Shoppe 1121 West Court Street Pasco, WA (509) Yokes 4905 Road 68 Pasco, WA (509) Pomeroy Pomeroy 764 Main St Pomeroy, WA (509) Port Angeles Jims and Home Health 424 E 2nd St Port Angeles, WA (360) Port Hadlock Tri-Area 93 Oak Bay Rd Port Hadlock, WA (360) Port Orchard South Park 1743 Village Ln SE Port Orchard, WA (360) Port Townsend Dons 1151 Water St Port Townsend, WA (360) Jefferson Family 2005 E Sims Way Port Townsend, WA (360)

23 Retail Pharmacies, including Chain Pharmacies Poulsbo Kitsap th Ave NE Poulsbo, WA (360) Prosser Elfers Lyon 820 Memorial Street Prosser, WA (509) Pullman Sid's 825 SE Bishop Blvd Pullman, WA (509) ,, Puyallup Kirks at Hartland th St SE Puyallup, WA (253) Kirks at Sunrise Sunrise Blvd E Puyallup, WA (253) , Raymond Raymond 515 Commercial St Raymond, WA (360) Renton HimeRx 3901 NE 4th St Renton, WA (425) Prescription Pad 3915 Talbot Rd S Renton, WA (425) Prescription Pad 400 S 43rd St Renton, WA (425) Ready Meds 1412 SW 43rd St Renton, WA (425) Sams 901 South Grady Way Renton, WA (425) Republic Republic Drug Store 6 N Clark Ave Republic, WA (509) Richland Rx 800 Swift Blvd Richland, WA (509) , Yokes 454 Keene Rd Richland, WA (509) Ritzville Ritzville Drug 209 W Main Ave Ritzville, WA (509) Seattle Ballard Plaza 1801 NW Market St Seattle, WA (206) , Bob Johnsons 1407 NW 85th St Seattle, WA (206) , Cabrini Services 901 Boren Ave Seattle, WA (206) Chesterfield 720 7th Ave Seattle, WA (206) Columbia 4741 Rainier Ave S Seattle, WA (206) Eastern's 515 Minor Ave Seattle, WA (206) , 19

24 Retail Pharmacies, including Chain Pharmacies Harborview Medical Center 325 9th Ave Seattle, WA (206) Kattermans 5400 Sand Point Way NE Seattle, WA (206) , King Plaza 7101 MLK Jr Way S Seattle, WA (206) Lowrys Prescriptions Meridian Ave N Seattle, WA (206) , Lukes 611 Maynard Ave S Seattle, WA (206) , Meridian Meridian Ave N Seattle, WA (206) , Nguyens 1221 S Main St Seattle, WA (206) Nguyens 2120 Rainer Ave S Seattle, WA (206) , Northwest Medication Management 4120 Stone Way N Seattle, WA (206) Ottersens Pharmaceutical Greenwood Ave N Seattle, WA (206) Pacific Medical Centers th Ave NE Seattle, WA (206) Pacific Medical Centers 1101 Madison Seattle, WA (206) Pacific Medical Centers th Ave S Seattle, WA (206) Park's 401 NE Ravenna Blvd Seattle, WA (206) Sams Aurora Ave N Seattle, WA (206) Seattle Meds 1305 Madison Street Seattle, WA (206) Union Center 2324 Eastlake Ave E Seattle, WA (206) University of Washington Medical Center Ambulatory 1959 NE Pacific St Seattle, WA (206) Sedro Woolley Hometown 640 Hwy 20 Sedro Woolley, WA (360) Skagit Regional Clinics Sedro-Woolley 1990 Hospital Dr Sedro Woolley, WA (360) Selah Howards Drug 119 E 3rd Ave Selah, WA (509) Save On Foods 800 N Park Ctr Selah, WA (509)

25 Retail Pharmacies, including Chain Pharmacies Shelton Kamilche 90 SE Klah-Che-Min Dr Shelton, WA (360) Neils 512 W Franklin Shelton, WA (360) Shelton 110 W K St Shelton, WA (360) The Medicine Shoppe 207 Professional Way Shelton, WA (360) , Snoqualmie Ridge 7730 Center Blvd SE Snoqualmie, WA (425) The Falls 8112 Railroad Ave SE Snoqualmie, WA (425) South Bend South Bend 101 Willapa Ave South Bend, WA (360) Spanaway Spanaway Pacific Ave S Spanaway, WA (253) Spokane 1st Ave 6 E 1st Ave Spokane, WA (509) , Bates 3704 N Nevada Spokane, WA (509) , Hart and Dilatush 601 W Riverside Spokane, WA (509) , Kmart 4110 E Sprague Ave Spokane, WA (509) Lidgerwood Owl 5901 N Lidgerwood St Spokane, WA (509) Providence Sacred Heart Outpatient 101 W 8th Ave Spokane, WA (509) Riverpoint 528 E Spokane Falls Blvd Spokane, WA (509) Rosauers 1808 W 3rd Ave Spokane, WA (509) Rosauers 907 W 14th Ave Spokane, WA (509) Rosauers 1724 W Francis Ave Spokane, WA (509) Rosauers 2610 E 29th Ave Spokane, WA (509) Rosauers 9414 N Division St Spokane, WA (509) Rosauers E Sprague Ave Spokane, WA (509) , 21

26 Retail Pharmacies, including Chain Pharmacies Sixth Avenue Medical 508 W 6th Ave Spokane, WA (509) ,, The Medicine Shoppe E Sprague Spokane, WA (509) , The Medicine Shoppe 1327 W Northwest Blvd Spokane, WA (509) , Yokes 4235 S Cheney Spokane Rd Spokane, WA (509) Yokes 210 N Foothills Dr Spokane, WA (509) Yokes 3321 W Indian Trail Rd Spokane, WA (509) Spokane Valley Yokes E Sprague Ave Spokane Valley, WA (509) Yokes 9329 E Montgomery Spokane Valley, WA (509) St John St John 10 E Front St St John, WA (509) Stevenson Wind River 280 SW 2nd St Stevenson, WA (509) Sumas Sumas Drug 1143 Cherry St Sumas, WA (360) Sumner Nicholsons 910 Alder Ave Sumner, WA (253) Tacoma Chung 9122 S Tacoma Way Tacoma, WA (253) Cost Less Prescriptions 5431 Pacific Ave Tacoma, WA (253) Franciscan 1608 S J St Tacoma, WA (253) Lincoln 821 S 38th St Tacoma, WA (253) , Mai Linh 1211 S 11th St Tacoma, WA (253) Mega th St S Tacoma, WA (253) Multicare Clinic 521 MLK Jr Way Tacoma, WA (253) Parkland Marketplace Pacific Ave S Tacoma, WA (253) Puget Sound 710 S 38th St Tacoma, WA (253) , 22

27 Retail Pharmacies, including Chain Pharmacies Rankos Stadium 101 Tacoma Ave N Tacoma, WA (253) Tacoma Medical Center 1206 S 11th St Tacoma, WA (253) Tekoa Tekoa 124 N Crosby Tekoa, WA (509) Tenino Heddens 196 W Sussex Ave Tenino, WA (360) Tonasket Roys 318 S Whitcomb Tonasket, WA (509) Toppenish Gibbons 117 S Toppenish Ave Toppenish, WA (509) Tulalip Tulalip th Ave NE Tulalip, WA (360) Tumwater Martin's Southgate Drug 5201 Capitol Blvd S Tumwater, WA (360) Yauger Park Family 1625 Mottman Rd SW Tumwater, WA (360) , Twisp Ulrichs Valley 423 E Methow Hwy Twisp, WA (509) Vancouver Apothecary at Salmon Creek 2121 NE 139th St Vancouver, WA (360) Hi School 3200 NE 52nd St Vancouver, WA (360) , PHSW at Medical Center 420 NE Mother Joseph Pl Vancouver, WA (360) The Vancouver Clinic 700 NE 87th Ave Vancouver, WA (360) Walla Walla Adventist Health Community 1111 S 2nd Ave Walla Walla, WA (509) Tallmans 4 W Main St Walla Walla, WA (509) Wapato Horizon 633 W 1st St Wapato, WA (509) Wenatchee Central Washington Hospital Professional 1201 S Miller St Wenatchee, WA (509) Wenatchee Clinic 820 N Chelan Ave Wenatchee, WA (509) ,, West Richland Yokes 1401 Bombing Range Rd West Richland, WA (509)

28 Retail Pharmacies, including Chain Pharmacies Westport Twin Harbor 733 N Montesano St Westport, WA (360) White Salmon Hi School 291 E Jewett Blvd White Salmon, WA (509) Winlock Cedar Village 206 E Walnut Street Winlock, WA (360) Woodinville Bellegrove nd Ave NE Woodinville, WA (425) , Woodinville th Ave NE Woodinville, WA (425) , Woodland Hi School 1365 Lewis River Rd Woodland, WA (360) , Yakima Barton's Center 1011 W Spruce St Yakima, WA (509) River Village 3708 Tieton Dr Yakima, WA (509) Rosauers 410 S 72nd Ave Yakima, WA (509) Terrace Village 4040 Terrace Heights Dr Yakima, WA (509) Tieton Village Drug 3708 Tieton Dr Yakima, WA (509) Wrays Chalet Thriftway 5605 Summitview Ave Yakima, WA (509) Wrays Thriftway 7200 W Nob Hill Blvd Yakima, WA (509) Yakima Valley Memorial Hospital 2811 Tieton Dr Yakima, WA (509) Yelm Tims and Gift Shop 106 1st St S Yelm, WA (360) , 24

29 Mail Order Pharmacies You can get prescription drugs shipped to your home through our network mail order delivery program. For refills of your mail order prescriptions, please contact your mail order pharmacy 14 days before you think the drugs you have on hand will run out to make sure your next order is shipped to you in time. Typically, you should expect to receive your prescription drugs within 14 days from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact us at (TTY users call 711) from 7 a.m. to 8 p.m., Pacific Time, seven days a week from October 1 through February 14 (after February 15 your call will be handled by our automated phone system Saturdays, Sundays and holidays). Postal Prescription Services (503) Walmart (800) Costco (800) Wellpartner (503) pharmacy.wellpartner.com Walgreens (800) walgreens.com/pharmacy 25

30 Home Infusion Pharmacies Moda Health will cover home infusion therapy if: Your prescription drug is on the Moda Health formulary or you have a formulary exception; Moda Health has approved your prescription drug for home infusion therapy; and Your prescription is written by an authorized prescriber. If you have questions regarding Home Infusion Pharmacies please call our Customer Service number at (TTY users call 711) from 7 am to 8 pm, Pacific Time, seven days a week from October 1 through February 14 (after February 15 your call will be handled by our automated phone system Saturdays, Sundays and holidays). Oregon Bend Briovarx Infusion Services 2065 NE Williamson Ct Bend, OR (541) Option Care at Legacy Health 2275 NE Doctors Dr Bend, OR (541) Eugene Home Parenteral Care 1000 S Bertelsen Rd Eugene, OR (541) Sacred Heart Home Infusion 677 E. 12th Ave Eugene, OR (541) Portland Coram CVS Specialty Infusion Services 7358 SW Durham Rd Portland, OR (503) Option Care at Legacy Health SW 72nd Ave Portland, OR (503) Providence Specialty Services - Infusion 6410 NE Halsey Street Portland, OR (503) Washington Bellingham Infusion Solutions 134 Prince Ave Bellingham, WA (360) Option Care 600 Birchwood Ave Bellingham, WA (360) Everett Option Care St SW Everett, WA (425) Kennewick Option Care 7325 Deschutes Ave Kennewick, WA (509) Redmond Coram CVS Specialty Infusion Services NE 87th St Redmond, WA (800) Seattle Option Care Gateway Dr Seattle, WA (206) Spokane Valley Coram CVS Specialty Infusion Services 5511 E 3rd Ave Spokane Valley, WA (888) Option Care 3310 N Pines Rd Spokane Valley, WA (509)

31 Home Infusion Pharmacies Preferred Homecare Infusion E Sprague Ave Spokane Valley, WA (509) Providence Infusion and Services E Montgomery Dr Spokane Valley, WA (509) Tukwila Providence Infusion And Services 3333 S 120th Place Tukwila, WA (425) Wenatchee Central Washington Home Infusion 1201 S Miller Wenatchee, WA (509)

32 Long-Term Care Pharmacies Residents of a long-term care facility may access their prescription drugs covered under Moda Health Plan Inc. through the facility s long-term care pharmacy or another network long-term care pharmacy. If you have questions regarding Long Term Care Pharmacies please call our Customer Service number at (TTY users call 711) from 7 a.m. to 8 p.m., Pacific Time, seven days a week from October 1 through February 14 (after February 15 your call will be handled by our automated phone system Saturdays, Sundays and holidays). Oregon Albany Medicap 1333 Clay Street SE Albany, OR (541) Bend Briovarx Infusion Services 2065 NE Williamson Ct Bend, OR (541) Canby Parsons Canby 294 NW 2nd Ave Canby, OR (503) Clackamas Isse Services SE 114th Ave Clackamas, OR (503) Clatskanie Ricks Hi School 401 West Columbia River Hwy Clatskanie, OR (503) Corvallis Pill Box Health Center 906 NW Kings Blvd Corvallis, OR (541) Estacada Hi School 207 S Broadway Estacada, OR (503) Eugene BHS 1455 Westec Dr Eugene, OR (541) Hirons Drug 185 E 18th Ave Eugene, OR (541) Managed Healthcare 1750 Willow Creek Cir Eugene, OR (541) Payless Drug-Lane County 2411 MLK Jr Blvd Eugene, OR (503) Payless LTC 2920 Chad Dr Eugene, OR (503) Florence Florence 2935 Hwy 101 Florence, OR (541) Grants Pass Grants Pass 414 SW 6th St Grants Pass, OR (541) Trinity Valley 2001 NE Foothill Blvd Grants Pass, OR (541) Gresham Genoa 400 NE 7th St Gresham, OR (503) Independence Hi School 1357 Monmouth Ave Independence, OR (503)

33 Long-Term Care Pharmacies John Day Lens Drug 120 E Main St John Day, OR (541) La Grande Red Cross Institutional 206 Depot St La Grande, OR (541) Medford Asante 2900 E Barnett Rd Medford, OR (541) Omnicare of Medford 259 E Barnett Rd Medford, OR (541) Pharmblue Oregon 140 S Holly St Medford, OR (800) Rogue Valley Manor 1250 Mira Mar Ave Medford, OR (541) West Main Drug 2355 West Main St Medford, OR (541) Milwaukie Consonus Services 4560 SE International Way Milwaukie, OR (971) Geneva Woods SE Mcloughlin Blvd Milwaukie, OR (503) Molalla Cutter's Hi School 103 Robbins St Molalla, OR (503) Mt Angel Mt Angel Drug 105 N Main St Mt Angel, OR (503) Ontario PHS LTC 1085 N Oregon St Ontario, OR (541) Oregon City Genoa 998 Library Ct Oregon City, OR (503) Genoa 1425 Beavercreek Rd Oregon City, OR (971) SE Powell Blvd Portland, OR (503) Fairleys Healthcare 7206 NE Sandy Blvd Portland, OR (503) Gateway Medical 1125 NE 99th Ave Portland, OR (503) Luke-Dorf NE Sandy Blvd Portland, OR (503) Omnicare of Portland NE Glenn Widing Dr Portland, OR (503) Providence Specialty Services - LTC 6410 NE Halsey Street Portland, OR (503) Rogue River Rogue River 506 E Main Rogue River, OR (541) Salem Genoa 3180 NE Center Street Salem, OR (503) Oak Tree 2940 Commercial St SE Salem, OR (503) Scappoose Hi School SW Chinook Plaza Scappoose, OR (503)

34 Long-Term Care Pharmacies Sheridan Sheridan 103 E Main St Sheridan, OR (503) Silverton Hi School 406 McClaine St Silverton, OR (503) Silverton Pill Box 302 N First St Silverton, OR (503) Sisters Sisters Drug and Gift 211 E Cascade Sisters, OR (541) Stayton Sublimity 102 Martin Dr Stayton, OR (503) Vale Malheur Drug 198 A St W Vale, OR (541) West Linn Hi School 5639 NE Hood St West Linn, OR (503) Winston Valley Drugs 157 NW Douglas Blvd Winston, OR (541) Woodburn Woodburn Health Center 1475 Mount Hood Ave Woodburn, OR (971) Washington Arlington Arlington 540 N West Ave Arlington, WA (360) Auburn Genoa 2704 I Street NE Auburn, WA (253) Genoa 4508 Auburn Way N Auburn, WA (253) Bellingham Custom Prescription Shoppe 1313 E Maple St Bellingham, WA (360) Hoagland 2330 Yew St Bellingham, WA (360) Hoagland 1414 Meador Ave Bellingham, WA (360) Bremerton Genoa 5455 Almira Drive NE Bremerton, WA (360) Buckley Rainier School 2120 Ryan Rd Buckley, WA (360) Burien Genoa 1210 SW 136th St Burien, WA (206) Camano Island Marks Camano 370 NE Camano Dr Camano Island, WA (360) Cashmere Doane's Senior Care 108 Elberta Ave Cashmere, WA (509) Doane's Valley 119 Cottage Ave Cashmere, WA (509)

35 Long-Term Care Pharmacies Castle Rock Castle Rock 117 1st Ave SW Castle Rock, WA (360) Cathlamet Cathlamet 74 Main St Cathlamet, WA (360) Centralia Genoa 2428 West Reynolds Ave Centralia, WA (360) Providence Centralia Hospital Retail 914 S Scheuber Rd Centralia, WA (360) Chewelah Akers United Drug 406 N Park St Chewelah, WA (509) Valley Drug 102 E Main Ave Chewelah, WA (509) Clarkston Owl Tri-State 1275 Highland Ave Clarkston, WA (509) Wasem's 800 6th St Clarkston, WA (509) Clinton Island Drug State Route 525 Clinton, WA (360) Colville Providence NE Washington Medical Group 1200 E Columbia Ave Colville, WA (509) Davenport Lincoln County Healthmart 621 Morgan S Davenport, WA (509) Deer Park Chas North County 401 S Main St Deer Park, WA (509) Edmonds Stevens Health Center LTC th Ave W Edmonds, WA (425) Everett Genoa 3322 Broadway Everett, WA (425) Payless LTC 111 SE Everett Mall Way Everett, WA (503) Fairfield Owl 208 E Main St Fairfield, WA (509) Gig Harbor Costless Senior Services nd Ave NW Gig Harbor, WA (253) Kennewick Reliant Rx 4123 W 24th Ave Kennewick, WA (509) Kent Pharmerica th Ave S Kent, WA (425) Propac 7102 S 220th St Kent, WA (253) United Care - LTC E Valley Hwy Kent, WA (425) La Conner La Conner Drug 708 E Morris St La Conner, WA (360)