DIRECTORY. UnitedHealthcare MedicareRx for Groups (PDP)

Transcription

1 2015 Pharmacy DIRECTORY UnitedHealthcare MedicareRx for Groups (PDP) This directory is a partial list of network pharmacies near you. This directory is for Utah. For more information, please call Customer Service at: Toll-Free , TTY a.m. to 8 p.m. local time, Monday through Friday Y0066_140805_ Last updated October 2014

2 About this PHARMACY DIRECTORY This directory is a partial list of the plan s network pharmacies. It lists pharmacies in your area based on your State. Pharmacies are listed in alphabetical order. 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 may no longer be in our network, or there may be newer pharmacies in our network that are not listed. It is current as of the date printed on the front and back cover pages of this directory. For the most current list of our network pharmacies, please see the front and back cover pages of this directory for information on how to contact us. Network pharmacies A network pharmacy is a pharmacy where you get prescription drug benefits provided by your plan. We call the pharmacies in this directory our network pharmacies because we have made arrangements with them to provide prescription drugs to our plan members. In most cases, your prescriptions are covered under the plan only if they are filled at one of our network pharmacies or through a mail order service pharmacy. We have a large service area with many pharmacies where you may fill your prescription drugs. This directory lists network pharmacies in your area. For information about additional network pharmacies, please contact us using the information on the front and back cover pages. You do not have to use the same network pharmacy every time you fill a prescription drug. You may use any of our network pharmacies. In certain situations we may cover prescriptions filled at pharmacies outside of the network. Please see your Evidence of Coverage for more information. For a complete description of your prescription drug coverage, including how to fill your prescriptions, please see your Evidence of Coverage and Drug List (Formulary). If you have questions about any of the above, please see the front and back cover pages of this directory for information on how to contact us. Pharmacy Saver Pharmacy Saver is a cost savings prescription drug program available to our plan members. The plan has worked with many of our network pharmacies to offer even lower prices on many common prescription drugs. 1 To learn more about Pharmacy Saver or to see the full list of participating pharmacies, visit Pharmacies included in the Pharmacy Saver program are indicated by a listings on the following pages. symbol in the pharmacy

3 Mail order service pharmacy A network mail service pharmacy is where members can get their prescription drugs delivered to their mailbox. You may go to any of the plan s network mail service pharmacies to get your covered prescription drugs. You can use one of the plan s mail service pharmacies in our network, OptumRx Mail Service Pharmacy. Members can get a 90-day supply 2 of some of their prescription drugs. Members may also use other mail service pharmacies to fill prescriptions. You are not required to use OptumRx to obtain a 90-day supply of your maintenance medications, but you may pay more out-of-pocket compared to using OptumRx, your plan s Mail Service Pharmacy. Prescription orders sent directly to OptumRx from your doctor must have your approval before OptumRx can send your medications. This includes new prescriptions and prescription refills. OptumRx will contact you, by phone, to get your approval. At that time you may also tell OptumRx to fill any future prescriptions they receive directly from your doctor(s) for up to one year. If OptumRx is unable to reach you for approval your prescription will not be sent to you. Refunds may be available for prescriptions you did not approve and did not want. You may request a refund or cancel your approval by calling OptumRx at , TTY 711, 24 hours, 7 days a week. New prescriptions should arrive within ten business days from the date the completed order is received by the Mail Service Pharmacy. Completed refill orders should arrive in about seven business days. OptumRx will contact you if there will be an extended delay in the delivery of your medications. You can find more information about Mail Service Pharmacy by calling OptumRx at the number listed in the Mail service pharmacies section of this directory. Mail service pharmacies are indicated by a symbol in the pharmacy listings on the following pages.

4 90-day supplies from retail pharmacies You do not have to use a mail service pharmacy to get a 90-day supply of your prescription drugs. Some of the retail pharmacies in the plan s network also offer 90-day supplies of prescription drugs. If you fill a 90-day supply at a retail pharmacy, you may pay more. Retail pharmacies in the network that fill 90-day supplies of prescription drugs are indicated by a symbol in the pharmacy listings on the following pages. E-prescribing Some of our network pharmacies use electronic prescribing, or e-prescribing. The pharmacy receives your prescriptions electronically, directly from your doctor. Your prescription may be sent before you even leave your doctor s office. E-prescribing can be a safe and efficient way for network pharmacies to get your prescriptions. It may help the pharmacy avoid reading mistakes and may alert your doctor to drugs that should not be taken together. Network pharmacies that use e-prescribing are indicated by an the following pages. symbol in the pharmacy listings on

5 National pharmacy chains Below are some of the national chains in the plan s pharmacy network. For locations and phone numbers of stores in your area, call the numbers shown below. Duane Reade Food Lion Giant Giant Food Stores Hannaford H-E-B Hy-Vee Kroger & Affiliates Baker s Pharmacy City Market Dillons Fred Meyer Fry s Pharmacy Gerbes JayCs King Soopers Kroger Pay Less Pharmacy QFC Pharmacy Ralphs Scotts Smith s Food & Drug Martins Publix Safeway & Affiliates Carrs Quality Center Pavilion's Randalls Safeway Tom Thumb Vons Sam s Club Stop & Shop Target Pharmacy Thrifty White TTY Walmart Wegmans TTY users should call 711, unless a different phone number is listed. This list may change. For a current list of national pharmacy chains or to check for a pharmacy not listed in this directory, call us at the number located on the front and back cover pages of this directory.

6 Below are some of the retail and chain pharmacies in your area. Note: Pharmacies may have closed or moved locations since this directory was printed. Other pharmacies are available in our network. Beaver Beaver Drug and Gift 98 N Main Beaver, UT , TTY: 711 Box Elder Brigham Pharmacy 1017 S Medical Drive Brigham City, UT , TTY: 711 Kent's Pharmacy 260 N Main Brigham City, UT , TTY: 711 Tremonton Community Phcy Inc 44 E Main St Tremonton, UT , TTY: South Commerce Way Perry, UT , TTY: 711 Cache Cache Valley Pharmacy 2380 N 400E Ste E North Logan, UT , TTY: 711 Kents Pharmacy 300 E Main St Tremonton, UT , TTY: 711 Kmart Pharmacy 1750 N Main Logan, UT , TTY: 711 Shopko Pharmacy 747 S Main St Brigham City, UT , TTY: 711 Larrys Smithfield Pharmacy Inc 502 S Main Ste B Smithfield, UT , TTY: South Main Brigham City, UT , TTY: 711 Lees Marketplace Logan Pharmac 555 East 1400 North Logan, UT , TTY: 711

7 Lees Marketplace Pharmacy-Smithf 850 S Main Smithfield, UT , TTY: East 442 North Logan, UT , TTY: 711 Maceys Pharmacy 49 E 400 N Logan, UT , TTY: 711 Spences North Pharmacy 550 E 1400 N Logan, UT , TTY: 711 Maceys Pharmacy 50 North Hwy 165 Providence, UT , TTY: 711 Reeds Pharmacy 790 E Main Hyrum, UT , TTY: 711 Sams Pharmacy 145 West Cache Valley Blvd Logan, UT , TTY: 711 Shopko Pharmacy 1341 N Main St Logan, UT , TTY: North Main Street Logan, UT , TTY: 711 Student Health Pharmacy 850 East 1200 North Logan, UT , TTY: S 100 W Logan, UT , TTY: North Main North Logan, UT , TTY: N Main St Logan, UT , TTY: 711 Carbon Carbon Med Serv Pharmacy 305 Center St East Carbon, UT , TTY: 711

8 Fresh Market Pharmacy 760 W Price River Dr Price, UT , TTY: 711 Kmart Pharmacy 610 West Price River Drive Price, UT , TTY: East Main St Price, UT , TTY: South Highway 55 Price, UT , TTY: 711 Davis Care Pharmacy 109 W Gentile St Layton, UT , TTY: 711 Bowmans Pharmacy 326 N Main St Kaysville, UT , TTY: 711 Centerville Pharmacy 26 S Main St Ste 100 Centerville, UT , TTY: 711 Costco Pharmacy 573 W 100 N West Bountiful, UT , TTY: 711 Davis Drug 1580 W Antelope Dr Ste 130A Layton, UT , TTY: 711 Dicks Family Pharmacy 2280 S Orchard Dr Bountiful, UT , TTY: 711 Dicks Pharmacy 84 W Parrish Ln Centerville, UT , TTY: 711 Firestone Pharmacy, LLC 450 S. 400 E. Bountiful, UT , TTY: 711

9 Fresh Market Pharmacy 170 W 200 N Kaysville, UT , TTY: 711 Macey's Pharmacy 2062 W 1800 N Clinton, UT , TTY: 711 Fresh Market Pharmacy 910 N Fairfield Rd Layton, UT , TTY: 711 Medicine Shoppe Pharmacy 47 East 500 South Bountiful, UT , TTY: 711 Harmons Pharmacy Station Park 200 N Station Parkway Farmington, UT , TTY: 711 Island View Pharmacy 2038 W 1900 S Syracuse, UT , TTY: 711 Kent's Pharmacy Clearfield 580 So. State Street Clearfield, UT , TTY: 711 Kmart Pharmacy 680 West 2600 South Woods Cross, UT , TTY: 711 Mountain View Pharmacy 425 S Medical Dr Ste 100 Bountiful, UT , TTY: 711 North View Pharmacy 2121 N Robbins Dr Layton, UT , TTY: 711 Orchard Drug 51 S 130 E North Salt Lake, UT , TTY: 711 Professional Plaza Phcy Inc 2065 N Robbins Dr Layton, UT , TTY: 711 Kmart Pharmacy 2010 N Main Layton, UT , TTY: 711

10 Rite Aid Pharmacy 535 South Main Street Bountiful, UT , TTY: East Gentile Layton, UT , TTY: 711 Rite Aid Pharmacy 860 North Fairfield Road Rainbow Plaza Layton, UT , TTY: 711 Sams Pharmacy 1055 W Hillfield Road Layton, UT , TTY: 711 Shopko Pharmacy 190 S 500 W Bountiful, UT , TTY: 711 Shopko Pharmacy 1150 N Main St Layton, UT , TTY: North Main St Sunset, UT , TTY: S Main St Bountiful, UT , TTY: North Highway 89 Farmington, UT , TTY: West 1700 South Syracuse, UT , TTY: South 200 West Bountiful, UT , TTY: 711 Target Pharmacy 200 North Market Place Dr Centerville, UT , TTY: 711 Target Pharmacy 815 West 2000 North Layton, UT , TTY: 711

11 Tibbitts Family Pharmacy 2940 N Church St Ste 201 Layton, UT , TTY: West Parrish Lane Centerville, UT , TTY: 711 Valu Drug 1080 W 300 North Clearfield, UT , TTY: S Main St Woods Cross, UT , TTY: 711 Value Med Rx, LLC 450 S. 400 E. Ste 70 Bountiful, UT , TTY: West Hill Field Road Layton, UT , TTY: West 1700 South Syracuse, UT , TTY: North 2000 West Clinton, UT , TTY: East Highway 193 Layton, UT , TTY: N Main St Kaysville, UT , TTY: W 1800 N Clinton, UT , TTY: W 1700 S Syracuse, UT , TTY: W 2000 N Antelope Dr Layton, UT , TTY: S 500 W Bountiful, UT , TTY: 711

12 Winegars Pharmacy 3341 S Orchard Dr Bountiful, UT , TTY: 711 Duchesne A&W Pharmacy 171 E Main St Duchesne, UT , TTY: 711 Basin Family Pharmacy 245 West Hwy 40 Roosevelt, UT , TTY: 711 Davis Food and Drug Pharmacy 750 E 200 N Roosevelt, UT , TTY: 711 Duchesne Valley Medical Clinic P 50 East 200 South Duchesne, UT , TTY: 711 Uintah Basin Med Cnt Phcy Op 250 W 300 N 75-2 Roosevelt, UT , TTY: 711 Emery Boyds Family Pharmacy 25 W Main St Castledale, UT , TTY: 711 Garfield Kazan Pharmacy 65 North Center Street Escalante, UT , TTY: 711 Panguitch Drug 95 E Center Panguitch, UT , TTY: 711 Grand City Market Pharmacy 425 S Main Street Moab, UT , TTY: 711 Walker Drug 290 S Main St Moab, UT , TTY: 711 Iron Bullochs Drug Store 91 N Main St Cedar City, UT , TTY: 711

13 Lins Supermarket Pharmacy 150 N Main Cedar City, UT , TTY: 711 Parowan Drug and Gift 20 N Main Parowan, UT , TTY: S Main St Cedar City, UT , TTY: 711 Township Professional Pharmacy 108 West 1325 North Cedar City, UT , TTY: So. Providence Center Dr. Cedar City, UT , TTY: W Cross Hollow Dr Cedar City, UT , TTY: 711 Juab Central Valley Comm Phcy 152 W 1500 N Nephi, UT , TTY: 711 Mt Nebo Pharmacy 965 N Main St Nephi, UT , TTY: 711 Kane Kanab United Drug 57 W Center St Kanab, UT , TTY: 711 Zion Pharmacy 14 E Center St Kanab, UT , TTY: 711 Millard Lovell Pharmacy 111 E Main St Delta, UT , TTY: 711 Service Drug 40 N Main St Fillmore, UT , TTY: 711

14 Service Drug Company Inc 215 W Main Delta, UT , TTY: 711 Apothecary West 4188 W 5415 South Kearns, UT , TTY: 711 Morgan Morgan Drug 109 N Commercial Morgan, UT , TTY: 711 Ridley's Pharmacy 275 E 300 N Morgan, UT , TTY: 711 Salt Lake Acupharm, LLC 1018 W Atherton Dr # 202 Salt Lake City, UT , TTY: 711 Amerita Inc S Progress Dr Salt Lake City, UT , TTY: 711 Amphex Pharmacy, LLC 898 E 3300 S Salt Lake City, UT , TTY: 711 CVS Pharmacy S 700 E Sandy, UT , TTY: 711 CVS Pharmacy 3148 W 3500 S West Valley City, UT , TTY: 711 CVS Pharmacy 4968 W S Herriman, UT , TTY: 711 Community Pharmacy 1220 E 3900 S Ste 1H Salt Lake City, UT , TTY: 711 Costco Pharmacy 3747 South 2700 West West Valley City, UT , TTY: 711

15 Costco Pharmacy S Auto Mall Drive Sandy, UT , TTY: 711 Davis Food & Drug 3765 S 2700 West West Valley City, UT , TTY: 711 Costco Pharmacy 1818 S 300 West Street Salt Lake City, UT , TTY: 711 Diabetes Specialty Center 3744 S SEcord St Ste A Salt Lake City, UT , TTY: 711 Costco Pharmacy 5201 S Intermountain Dr Murray, UT , TTY: 711 Dans Drug 2330 E 3300 S Salt Lake City, UT , TTY: 711 Dans Drug 2029 E 7000 S Salt Lake City, UT , TTY: 711 Family Plaza Pharmacy 3570 W 9000 S Ste 150 West Jordan, UT , TTY: 711 Five Star Specialty Pharmacy 2235 S 1300 W Ste D Salt Lake City, UT , TTY: 711 Fresh Market Pharmacy 4530 S Highland Dr Salt Lake City, UT , TTY: 711 Dans Drug 1360 S Foothill Dr Salt Lake City, UT , TTY: 711 Fresh Market Pharmacy 1860 E 9400 S Sandy, UT , TTY: 711 Dans Drugs 3981 S Wasatch Blvd Salt Lake City, UT , TTY: 711 Fresh Market Pharmacy 3555 W 3500 S West Valley City, UT , TTY: 711

16 Fresh Market Pharmacy 1212 Draper Pkwy Draper, UT , TTY: 711 Gibsons Pharmacy 240 E 6400 S Murray, UT , TTY: 711 Fresh Market Pharmacy 1638 S 9th E. Salt Lake City, UT , TTY: 711 Granger Pharmacy, LLC 3725 W 4100 S West Valley City, UT , TTY: 711 Fresh Market Pharmacy 2040 S 2300 E Salt Lake City, UT , TTY: 711 Greenwood Pharmacy 7495 S State St Midvale, UT , TTY: 711 Fresh Market Pharmacy 1825 W 4700 S Taylorsville, UT , TTY: 711 Harmons Apothecary Shop 3955 W 3500 S W Valley City, UT , TTY: 711 Fresh Market Pharmacy 5632 S 900 E Murray, UT , TTY: 711 Harmons City Inc East 7755 S 700 E Midvale, UT , TTY: 711 Fresh Market Pharmacy 3865 S 2300 E Salt Lake City, UT , TTY: 711 Harmons Pharmacy S Parkway Plaza Dr South Jordan, UT , TTY: 711 Genoa Healthcare 1020 S Main St Ste 100 Salt Lake City, UT , TTY: 711 Harmons Pharmacy 672 E South Draper, UT , TTY: 711

17 Harmons Pharmacy 3270 S 1300 E Salt Lake City, UT , TTY: 711 Harmons Pharmacy 135 E 100 S Salt Lake City, UT , TTY: 711 Harmons Pharmacy 4874 W 6200 S Kearns, UT , TTY: 711 Harmons Pharmacy 5454 S Redwood Rd Taylorsville, UT , TTY: 711 Harmons Pharmacy 125 E S Draper, UT , TTY: 711 Harmons Pharmacy S Redwood Rd South Jordan, UT , TTY: 711 Healthcare Pharmaceuticals Inc 3950 S 700 East Ste 205 Salt Lake City, UT , TTY: 711 Hospital Outpatient Pharmacy 50 N Medical Dr Salt Lake City, UT , TTY: 711 Huntsman Cancer Retail Pharmacy 1950 Circle of Hope Ste 2110 Salt Lake City, UT , TTY: 711 Hyland Pharmacy 1295 Miller Ave Ste 6 Salt Lake City, UT , TTY: 711 Isomeric Pharmacy Solutions 510 S 600 E Salt Lake City, UT , TTY: 711 Jolleys Corner Pharmacy 1676 E 1300 South Salt Lake City, UT , TTY: 711

18 Jolleys Corner Pharmacy 1702 S 1100 E Salt Lake City, UT , TTY: 711 La Farmacia De La Gente 2470 S Redwood Rd Ste 107 Salt Lake City, UT , TTY: 711 Jolleys Pharmacy Redwood 8806 S Redwood Rd West Jordan, UT , TTY: 711 Lifecare Specialty 1646 Sunrise Place Ste B West Jordan, UT , TTY: 711 Kmart Pharmacy 1442 W 90th South West Jordan, UT , TTY: 711 Lone Peak Pharmacy S State St Ste 102 Draper, UT , TTY: 711 Kmart Pharmacy 3330 S 5600 W St West Valley City, UT , TTY: 711 Kmart Pharmacy 1770 W 4100 S Salt Lake City, UT , TTY: 711 Kmart Pharmacy 4670 S 900 East Salt Lake City, UT , TTY: 711 Kmart Pharmacy 1055 W Draper Parkway Draper, UT , TTY: 711 M and M Prescription Service Inc S State St Ste 103 Draper, UT , TTY: 711 Maceys Pharmacy 7859 S 3200 W West Jordan, UT , TTY: 711 Maceys Pharmacy 7850 S 1300 E Sandy, UT , TTY: 711 Madsen Pharmacy 555 S Foothill Blvd Suite 396 Salt Lake City, UT , TTY: 711

19 Medical Center Pharmacy 1050 E South Temple Salt Lake City, UT , TTY: 711 Medical Plaza Pharmacy 508 E S Temple Suite124 Salt Lake City, UT , TTY: 711 Medipharm 1260 E Vine St Ste 5 Salt Lake City, UT , TTY: 711 Meds In Motion 3798 S 700 E Ste 7 Salt Lake City, UT , TTY: 711 Meier's Pharmacy 4698 Holladay Blvd Holladay, UT , TTY: 711 Millcreek Pharmacy 1260 E Vine St Salt Lake City, UT , TTY: 711 Moran Pharmacy 65 Mario Capecchi Drive Suite 2430 Salt Lake City, UT , TTY: 711 Mountain Care Pharmacy LLC 1030 W Bellwood Ln Murray, UT , TTY: 711 Olive Pharmacy 2290 S Redwood Rd West Valley City, UT , TTY: 711 Omnicare of Salt Lake City 2280 W Alexander St Salt Lake City, UT , TTY: 711 Oquirrh Mountain Pharmacy 3665 S 8400 W Magna, UT , TTY: 711 Orthopedic Pharmacy 590 Wakara Way Suite 2146 Salt Lake City, UT , TTY: 711 Peterson's Fresh Market 1784 W S Riverton, UT , TTY: 711

20 Pharmerica 376 W Lawndale Dr Salt Lake City, UT , TTY: 711 Pioneer Valley Pharmacy 4052 W Pioneer Parkway Suite 111 West Valley City, UT , TTY: 711 Rite Aid Pharmacy 1837 West 4700 South Taylorsville, UT , TTY: 711 Rite Aid Pharmacy 4714 Holladay Boulevard Holladay, UT , TTY: 711 Reams Pharmacy 2783 S State St Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 150 North 900 West Salt Lake City, UT , TTY: 711 Red Rock Pharmacy 450 S 900 E Ste 150 Slc, UT , TTY: 711 Redwood Pharmacy 1525 W 2100 S Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 2332 East 21st South Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 2378 East 7000 South Hillside Plaza Shopping Center Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 8645 South Highland Drive Sandy, UT , TTY: 711 Rite Aid Pharmacy 2266 East 3300 South Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 635 East 3300 South Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 220 South 7th East Salt Lake City, UT , TTY: 711

21 Rite Aid Pharmacy 72 South Main Street Salt Lake City, UT , TTY: 711 Senior Care Pharmacy of The West 380 Lawndale Dr Salt Lake City, UT , TTY: 711 Rite Aid Pharmacy 1166 East Draper Parkway Draper, UT , TTY: 711 Rite Aid Pharmacy 5540 South 9th Eeast Salt Lake City, UT , TTY: 711 Sams Pharmacy 6525 South State Street Murray, UT , TTY: 711 Sams Pharmacy 1905 S 300 W Salt Lake City, UT , TTY: 711 Sams Pharmacy South Jordan Gtwy South Jordan, UT , TTY: 711 Sams Pharmacy 7571 South 3800 West West Jordan, UT , TTY: 711 Shared Phcy Svcs 4843 Murray Blvd Murray, UT , TTY: 711 Shopko Pharmacy 4850 W 3500 S West Valley City, UT , TTY: 711 Shopko Pharmacy 2165 E 9400 S Sandy, UT , TTY: 711 Shopko Pharmacy 5959 S State St Murray, UT , TTY: 711 Shopko Pharmacy 2290 S 1300 E Salt Lake City, UT , TTY: 711 Shopko Pharmacy 1553 W 9000 S West Jordan, UT , TTY: 711

22 Shopko Pharmacy 5800 S Redwood Rd Salt Lake City, UT , TTY: South 1300 East Sandy, UT , TTY: 711 Silver Lining Health Solutions 9140 S State St Ste 201 Sandy, UT , TTY: West 9000 South West Jordan, UT , TTY: 711 Simplifyrx 394 W. Ironwood Drive South Salt Lake, UT , TTY: W S Herriman, UT , TTY: W South Jordan Parkway South Jordan, UT , TTY: East South Draper, UT , TTY: S 4000 West West Valley City, UT , TTY: East 4500 South Salt Lake City, UT , TTY: W 4100 S West Valley City, UT , TTY: South 900 West Salt Lake City, UT , TTY: South Redwood Rd West Jordan, UT , TTY: West 9000 South West Jordan, UT , TTY: 711

23 8055 West 3500 South Magna, UT , TTY: th Ave Salt Lake City, UT , TTY: S Redwood Rd West Valley City, UT , TTY: South Valley Street Salt Lake City, UT , TTY: West 600 North Salt Lake City, UT , TTY: East 9400 South Sandy, UT , TTY: East 7800 South Salt Lake City, UT , TTY: East 800 South Salt Lake City, UT , TTY: West 5300 South Murray, UT , TTY: E 2100 S Salt Lake City, UT , TTY: East Fort Union Blvd Midvale, UT , TTY: South 500 East Salt Lake City, UT , TTY: 711 Snowbird Pharmacy 9385 So Snowbird Center Dr Snowbird, UT , TTY: 711 South Jordan Pharmacy 5126 W. Daybreak Parkway Room 101 South Jordan, UT , TTY: 711

24 South Valley Compounding Pharmac S Crossing Dr Ste 14 Riverton, UT , TTY: 711 Target Pharmacy 7025 South Park Centre Dr Salt Lake City, UT , TTY: 711 Southeast Pharmacy Pc 2670 S 2000 E Salt Lake City, UT , TTY: 711 Target Pharmacy South State Street Sandy, UT , TTY: 711 Specialized Pharmacy Services 7351 Union Park Ave Midvale, UT , TTY: 711 Target Pharmacy 7779 S Jordan Landing Blvd West Jordan, UT , TTY: 711 Super Value Pharmacy 729 N Redwood Rd Salt Lake City, UT , TTY: 711 Target Pharmacy 6748 South Redwood Road West Jordan, UT , TTY: 711 Target Pharmacy South Parkway Plaza Dr South Jordan, UT , TTY: 711 Target Pharmacy 5518 W High Market Dr West Valley City, UT , TTY: 711 The Apothecary Shoppe 82 South 1100 East Suite 104 Salt Lake City, UT , TTY: 711 The Medicine Center 2036 E 6200 South Salt Lake City, UT , TTY: 711 Target Pharmacy 1110 S 300 W Salt Lake City, UT , TTY: 711

25 University Pharmacy 1320 E 200 South Salt Lake City, UT , TTY: South 3800 West West Jordan, UT , TTY: 711 Valley Pharmacy Inc 1819 W 3500 S Ste 1G West Valley City, UT , TTY: 711 Vrx City Creek 50 E South Temple Ste 145 Salt Lake City, UT , TTY: East Draper Parkway Draper, UT , TTY: South 4000 West West Valley City, UT , TTY: So Union Park Ave Midvale, UT , TTY: S 8400 W Magna, UT , TTY: South Hamilton View Rd Riverton, UT , TTY: E Parleys Way Salt Lake City, UT , TTY: South Redwood Road Taylorsville, UT , TTY: So Jordan Gateway Road South Jordan, UT , TTY: West 6200 South West Valley City, UT , TTY: 711

26 4627 South 900 East Salt Lake City, UT , TTY: West 6200 South Kearns, UT , TTY: South 5600 West West Valley City, UT , TTY: Fort Union Blvd Cottonwood Heights, UT , TTY: West Hope Avenue Salt Lake City, UT , TTY: W S Herriman, UT , TTY: West 9800 South South Jordan, UT , TTY: S 2000 E Sandy, UT , TTY: S Quarry Bend Dr Sandy, UT , TTY: S 700 E Sandy, UT , TTY: W South Jordan Pkwy South Jordan, UT , TTY: E 400 S Salt Lake City, UT , TTY: S 900 E Salt Lake City, UT , TTY: S State St Midvale, UT , TTY: 711

27 3291 S Highland Dr Salt Lake City, UT , TTY: W 4100 South West Valley, UT , TTY: E S Draper, UT , TTY: S Redwood Rd Taylorsville, UT , TTY: Holladay Blvd Salt Lake City, UT , TTY: S Redwood Rd South Jordan, UT , TTY: West 5415 South Taylorsville, UT , TTY: East 2100 South Salt Lake City, UT , TTY: S Redwood Rd Riverton, UT , TTY: S Redwood Rd West Jordan, UT , TTY: W 9000 S West Jordan, UT , TTY: 711 Westridge Pharmacy 3730 W 4700 S West Valley City, UT , TTY: E Draper Pkwy Draper, UT , TTY: 711

28 San Juan Blue Mountain Pharmacy 802 South 200 West Blanding, UT , TTY: 711 Montezuma Creek Chc Pharmacy East Hwy 262 Montezuma Creek, UT , TTY: 711 Monument Valley Health Center 30 West Medical Drive Monument Valley, UT , TTY: 711 Gunnison Family Pharmacy & Flora 77 S Main Gunnison, UT , TTY: 711 Gunnison Pharmacy 520 S Main Gunnison, UT , TTY: 711 Kents Pharmacy 475 S Main Ephraim, UT , TTY: 711 San Juan Pharmacy 65 S Main St Blanding, UT , TTY: 711 Skyline Pharmacy 1 W Main St Mount Pleasant, UT , TTY: 711 San Juan Pharmacy Monticello 140 S Main St Monticello, UT , TTY: 711 Terrels Pharmacy 1050 South State Mount Pleasant, UT , TTY: 711 Sanpete Anderson Drug 1 N Main St Ephraim, UT , TTY: N Main Ephraim, UT , TTY: 711

29 Sevier Aspen Ridge Pharmacy 515 N. Main Monroe, UT , TTY: 711 Fresh Market Pharmacy 250 S Main St Richfield, UT , TTY: 711 Kmart Pharmacy 1040 South US Highway 89 Richfield, UT , TTY: 711 Lennys Richfield Family Pharmacy 508 N Main St Richfield, UT , TTY: 711 Fresh Market Pharmacy 3151 W Kilby Rd Park City, UT , TTY: 711 Kamas Foodtown Pharmacy 146 W 200 S Kamas, UT , TTY: 711 Park City Clinic Pharmacy 750 Round Valley Drive #203 Park City, UT , TTY: 711 Redstone Pharmacy 1743 W Redstone Center Dr Ste 115 Park City, UT , TTY: East 1300 South Richfield, UT , TTY: 711 Rite Aid Pharmacy 950 Iron Horse Drive Park City, UT , TTY: 711 Summit Fresh Market Pharmacy 1760 Park Ave Park City, UT , TTY: West Uinta Way Kimball Junction, UT , TTY: 711

30 The Market Pharmacy 1500 Snow Creek Dr Park City, UT , TTY: 711 Maceys Pharmacy 972 N Main St Tooele, UT , TTY: North Landmark Drive Park City, UT , TTY: 711 Savon Pharmacy 740 N Main St Tooele, UT , TTY: 711 Tooele Birch Family Pharmacy 213 E Main St Grantsville, UT , TTY: 711 Stansbury Pharmacy 220 Millpond Rd Ste 100 Stansbury Park, UT , TTY: 711 Birch Family Pharmacy 6727 N. Hwy 36 Tooele, UT , TTY: West 1280 North Tooele, UT , TTY: 711 Birch Family Pharmacy 493 N Main St Tooele, UT , TTY: N Main St Tooele, UT , TTY: 711 Holt's Pharmacy 134 W 1180 N Ste 12 Tooele, UT , TTY: 711 Uintah Davis Food and Drug 575 W Main St Vernal, UT , TTY: 711

31 1080 West Highway 40 Vernal, UT , TTY: 711 Art City Pharmacy 405 S Main Springville, UT , TTY: 711 Unitah & Ouray Health Center 6822 E 1000 South Fort Duchesne, UT , TTY: 711 B & H Pharmacy 286 W Center Provo, UT , TTY: West Hwy 40 Vernal, UT , TTY: 711 Brighton Pharmacy 223 West South Sandy, UT , TTY: W Highway 40 Vernal, UT , TTY: 711 CVS Pharmacy 1235 N University Ave Provo, UT , TTY: 711 Utah Allen's Super Save Market 340 S Main St Springville, UT , TTY: 711 Allens Super Save Market 655 E 300 S Provo, UT , TTY: 711 Cecil's Pharmacy 300 Main St Lehi, UT , TTY: 711 Central Utah Pharmacy 1055 N 500 W Bld A Provo, UT , TTY: 711 Costco Pharmacy 198 North 1200 East Lehi, UT , TTY: 711

32 Costco Pharmacy 648 East 800 South Orem, UT , TTY: 711 Fresh Market Pharmacy 652 N 800 E Spanish Fork, UT , TTY: 711 Costco Pharmacy 273 East 1000 North Spanish Fork, UT , TTY: 711 Fresh Market Pharmacy 135 E Main American Fork, UT , TTY: 711 Dry Creek Pharmacy 3300 N Running Creek Way Bldg G Suite 100 Lehi, UT , TTY: 711 Edgemont Pharmacy 3661 N Canyon Rd Provo, UT , TTY: 711 Family Pharmacy 1172 E 100 N Ste 1 Payson, UT , TTY: 711 Fresh Market Pharmacy 560 W Center Provo, UT , TTY: 711 Harmons Pharmacy 870 E 800 N Orem, UT , TTY: 711 Healthwise Pharmacy 724 S 1600 W Mapleton, UT , TTY: 711 Kmart Pharmacy 900 E Expressway Lane Spanish Fork, UT , TTY: 711 Maceys Pharmacy 880 N State St Orem, UT , TTY: 711 Maceys Pharmacy 187 E 1000 N Spanish Fork, UT , TTY: 711

33 Maceys Pharmacy 1402 N State St Provo, UT , TTY: 711 Maceys Pharmacy 931 W State St Pleasant Grove, UT , TTY: 711 Maceys Pharmacy 760 E. Main Lehi, UT , TTY: 711 Maple Mountain Pharmacy 724 S W. Mapleton, UT , TTY: 711 Meridian Meds, LLC 220 N 1200 E Ste 104 Lehi, UT , TTY: 711 Mountainlands Family Pharmacy 589 S State St Provo, UT , TTY: 711 Mountainlands Family Pharmacy- W 750 N 200 W Suite 201 Provo, UT , TTY: 711 Orem Family Pharmacy 406 N State Street Orem, UT , TTY: 711 Parkway Pharmacy 145 W 1300 S Orem, UT , TTY: 711 Payson Market 586 N Main Payson, UT , TTY: 711 Precision Medical Pharmacy 726 S 400 E Orem, UT , TTY: 711 Ridley's Pharmacy 25 W Center St Orem, UT , TTY: 711

34 Ridley's Pharmacy 4045 E Pony Express Pkwy Eagle Mountain, UT , TTY: 711 Rite Aid Pharmacy 774 South State Street Orem, UT , TTY: 711 Ridley's Pharmacy 1585 N State St Orem, UT , TTY: 711 Rock Canyon Pharmacy 3179 N Canyon Rd Provo, UT , TTY: 711 Ridleys Pharmacy 5353 W North Highland, UT , TTY: 711 Salem Hills Pharmacy 118 N Main Salem, UT , TTY: 711 Rite Aid Pharmacy 1550 North State Street Orem, UT , TTY: 711 Salmon Pharmacy 450 West 800 N Orem, UT , TTY: 711 Rite Aid Pharmacy 1324 North State Street Riverxside Plaza Provo, UT , TTY: 711 Rite Aid Pharmacy 819 North Main Street Payson, UT , TTY: 711 Sams Pharmacy 1313 University Avenue Provo, UT , TTY: 711 Santaquin Pharmacy and Diabetes 27 W Main St Ste C1 Santaquin, UT , TTY: 711 Shopko Pharmacy 125 S State St Orem, UT , TTY: 711

35 Shopko Pharmacy 955 N Main St Spanish Fork, UT , TTY: East 700 South Pleasant Grove, UT , TTY: 711 Shopko Pharmacy 2266 N University Pkwy Provo, UT , TTY: South 100 West Payson, UT , TTY: 711 Smith Drug Co 10 S Main St Pleasant Grove, UT , TTY: 711 Sos Drug Company 214 S Main St Springville, UT , TTY: North Freedom Blvd Provo, UT , TTY: 711 Stone Drug Company 159 N Main St Spanish Fork, UT , TTY: South State St Orem, UT , TTY: 711 Target Pharmacy 608 W Main St American Fork, UT , TTY: North Redwood Rd Saratoga Springs, UT , TTY: 711 Target Pharmacy 175 West Center Street Orem, UT , TTY: East 3500 North Lehi, UT , TTY: 711 Taylor Drug 76 N 1100 E American Fork, UT , TTY: 711

36 949 West Grassland Drive American Fork, UT , TTY: West State Street Pleasant Grove, UT , TTY: W Cedar Hills Dr Cedar Hills, UT , TTY: N Redwood Rd Saratoga Springs, UT , TTY: S Sandhill Rd Orem, UT , TTY: S State St Orem, UT , TTY: South 1750 West Springville, UT , TTY: N State St Provo, UT , TTY: N University Pkwy Provo, UT , TTY: N State St Orem, UT , TTY: North State Street Lindon, UT , TTY: N 1200 E Lehi, UT , TTY: South Turf Farm Road Payson, UT , TTY: S Main St Springville, UT , TTY: 711

37 815 W State Rd Pleasant Grove, UT , TTY: S US 189 Heber City, UT , TTY: N Main St Payson, UT , TTY: S Main St Heber City, UT , TTY: 711 Walmart Pharmacy 136 W State Road 73 Saratoga Springs, UT , TTY: 711 Wasatch Day's Market Inc 890 S Main Heber City, UT , TTY: 711 Washington Brent's Pharmacy & Diabetes Care 1091 N Bluff St Saint George, UT , TTY: 711 Costco Pharmacy 835 North 3050 East St. George, UT , TTY: 711 Ridley's Pharmacy 42 W Main St Midway, UT , TTY: 711 Davis Food and Drug 495 N Main St La Verkin, UT , TTY: N Main St Heber City, UT , TTY: 711 Fusion Specialty Pharmacy 1100 Canyon View Dr Ste C Santa Clara, UT , TTY: 711

38 Harmons Pharmacy 1189 E 700 S St George, UT , TTY: 711 Rite Aid Pharmacy 615 East Saint George Boulevard St George, UT , TTY: 711 Hurricane Family Pharmacy 25 North 2000 West Hurricane, UT , TTY: 711 Savon Pharmacy 745 N Dixie Downs Dr St George, UT , TTY: 711 Kmart Pharmacy 745 South Bluff Saint George, UT , TTY: 711 Savon Pharmacy 915 W Redcliff Dr Washington, UT , TTY: 711 Lins Pharmacy 1120 W State St Hurricane, UT , TTY: North Bluff St St George, UT , TTY: 711 Lins Supermarket Pharmacy 1930 W Sunset Blvd St George, UT , TTY: 711 Stapley Pharmacy 102 E City Center St George, UT , TTY: 711 Omnicare of St. George 595 S Bluff St Ste 3 St George, UT , TTY: 711 Professional Park 736 S 900 E Ste 102 St George, UT , TTY: 711 Stapley Pharmacy at Dino Crossin 446 S Mall Dr B 8 St George, UT , TTY: 711 Target Pharmacy 275 South River Road St George, UT , TTY: 711

39 180 N 3400 W Hurricane, UT , TTY: South Pioneer Road St George, UT , TTY: W Telegraph St. Washington, UT , TTY: W State St Hurricane, UT , TTY: W Sunset Blvd St George, UT , TTY: W St George Blvd St George, UT , TTY: 711 Wayne Wayne Community Hlth Ctr Phcy 128 South 300 West Bicknell, UT , TTY: 711 Weber CVS Pharmacy 5305 S 1900 W Roy, UT , TTY: 711 Canyon View Health Mart Pharmacy 1159 E 12th St Ogden, UT , TTY: 711 Care First Pharmacy, LLC 5492 S Adams Ave Washington Terrace, UT , TTY: 711 Costco Pharmacy 3656 Wall Ave South Ogden, UT , TTY: 711 Fresh Market Pharmacy 5691 S Harrison Blvd South Ogden, UT , TTY: 711

40 Fresh Market Pharmacy 2044 Harrison Blvd Ogden, UT , TTY: 711 Mountain View Health Mart 1100 W 2700 N Pleasant View, UT , TTY: 711 Fresh Market Pharmacy 3945 Washington Blvd Ogden, UT , TTY: 711 Ogden Clinic Health Mart Pharmac 4650 Harrison Blvd Ogden, UT , TTY: 711 Harmons Ogden North 145 Harrisville Rd Ogden, UT , TTY: 711 Ridge View Pharmacy 3443 W 5600 S Roy, UT , TTY: 711 Kents Pharmacy 3535 W 5600 S Roy, UT , TTY: 711 Rite Aid Pharmacy 142 North Harrisville Road Ogden, UT , TTY: 711 Lee's Marketplace North Ogden 2645 N Washington Blvd North Ogden, UT , TTY: 711 Rite Aid Pharmacy th Street Ogden, UT , TTY: 711 Maceys Pharmacy 325 E. 36th St Ogden, UT , TTY: 711 Rite Aid Pharmacy 5673 South 1900 West Roy, UT , TTY: 711 Medicine Shoppe Pharmacy 2562 Monroe Boulevard Ogden, UT , TTY: 711 Roy Harmons Apothecary Shop 5370 S 1900 W Roy, UT , TTY: 711

41 Roy Winegars Pharmacy 3444 W 4800 S Roy, UT , TTY: 711 Target Pharmacy 1135 West Riverdale Rd Riverdale, UT , TTY: 711 Sams Pharmacy 4949 South 900 West St Riverdale, UT , TTY: 711 Th Street Pharmacy 698 E 12th St Ogden, UT , TTY: 711 Shopko Pharmacy 1018 Washington Blvd Ogden, UT , TTY: 711 Valley Pharmacy 2555 N Wolf Creek Dr Eden, UT , TTY: 711 Shopko Pharmacy 4060 Riverdale Rd Riverdale, UT , TTY: Wall Ave Ogden, UT , TTY: Harrison Blvd Ogden, UT , TTY: So. 900 West St Riverdale, UT , TTY: North 400 East Ogden, UT , TTY: Harrisville Road Harrisville, UT , TTY: Harrison Blvd Ogden, UT , TTY: Skyline Drive South Ogden, UT , TTY: 711

42 1208 Washington Blvd Ogden, UT , TTY: S 1900 W Roy, UT , TTY: E 6016 South Ogden, UT , TTY: 711 Wangsgard Health Mart Pharmacy 120 Washington Blvd Ogden, UT , TTY: N 400 E North Ogden, UT , TTY: 711 Wasatch Pharmacy Care 4387 Harrison Blvd D-7 Ogden, UT , TTY: th St Ogden, UT , TTY: 711 Mail service pharmacies Our mail service pharmacies will ship your prescription drugs directly to your home. For more information, please see your Evidence of Coverage. Below are the mail service pharmacies in the plan s network. OptumRx Mail Service P.O. Box 2975 P.O. Box , Orlando, FL Mission, KS P.O. Box 29061, Phoenix, AZ , TTY , TTY

43 Home infusion pharmacies near you The plan will cover home infusion therapy if: The plan has approved your prescription drug for home infusion therapy; and You get your prescription from an authorized prescriber. For more information, please see your Evidence of Coverage. Below are some of the home infusion network pharmacies in your area. Salt Lake Amerita Inc S Progress Dr Salt Lake City, UT , TTY: 711 Coram CVS/Specialty Infusion Ser 120 W Vine St Ste 140 Murray, UT , TTY: 711 Long-term care pharmacies near you Residents of a long-term care facility may get their covered prescription drugs from their facility s long-term care pharmacy or another network long-term care pharmacy. For more information, please see your Evidence of Coverage. Below are some of the long-term care network pharmacies in your area. Cache Cache Valley Pharmacy 2380 N 400E Ste E North Logan, UT , TTY: 711 Davis Care Pharmacy 109 W Gentile St Layton, UT , TTY: 711 Firestone Pharmacy, LLC 450 S. 400 E. Bountiful, UT , TTY: 711 Value Med Rx, LLC 450 S. 400 E. Ste 70 Bountiful, UT , TTY: 711 Garfield Panguitch Drug 95 E Center Panguitch, UT , TTY: 711 Kane Kanab United Drug 57 W Center St Kanab, UT , TTY: 711

44 Long-term care pharmacies near you Millard Service Drug Company Inc 215 W Main Delta, UT , TTY: 711 Salt Lake Acupharm, LLC 1018 W Atherton Dr # 202 Salt Lake City, UT , TTY: 711 Family Plaza Pharmacy 3570 W 9000 S Ste 150 West Jordan, UT , TTY: 711 Five Star Specialty Pharmacy 2235 S 1300 W Ste D Salt Lake City, UT , TTY: 711 Genoa Healthcare 1020 S Main St Ste 100 Salt Lake City, UT , TTY: 711 Healthcare Pharmaceuticals Inc 3950 S 700 East Ste 205 Salt Lake City, UT , TTY: 711 Jolleys Corner Pharmacy 1702 S 1100 E Salt Lake City, UT , TTY: 711 Lifecare Specialty 1646 Sunrise Place Ste B West Jordan, UT , TTY: 711 M and M Prescription Service Inc S State St Ste 103 Draper, UT , TTY: 711 Medical Plaza Pharmacy 508 E S Temple Suite124 Salt Lake City, UT , TTY: 711 Mountain Care Pharmacy LLC 1030 W Bellwood Ln Murray, UT , TTY: 711 Omnicare of Salt Lake City 2280 W Alexander St Salt Lake City, UT , TTY: 711 Pharmerica 376 W Lawndale Dr Salt Lake City, UT , TTY: 711

45 Long-term care pharmacies near you Red Rock Pharmacy 450 S 900 E Ste 150 Slc, UT , TTY: 711 Senior Care Pharmacy of The West 380 Lawndale Dr Salt Lake City, UT , TTY: 711 Shared Phcy Svcs 4843 Murray Blvd Murray, UT , TTY: 711 Silver Lining Health Solutions 9140 S State St Ste 201 Sandy, UT , TTY: 711 Simplifyrx 394 W. Ironwood Drive South Salt Lake, UT , TTY: 711 Specialized Pharmacy Services 7351 Union Park Ave Midvale, UT , TTY: 711 San Juan San Juan Pharmacy 65 S Main St Blanding, UT , TTY: 711 Sanpete Gunnison Family Pharmacy & Flora 77 S Main Gunnison, UT , TTY: 711 Skyline Pharmacy 1 W Main St Mount Pleasant, UT , TTY: 711 Utah B & H Pharmacy 286 W Center Provo, UT , TTY: 711 Family Pharmacy 1172 E 100 N Ste 1 Payson, UT , TTY: 711 Healthwise Pharmacy 724 S 1600 W Mapleton, UT , TTY: 711 Meridian Meds, LLC 220 N 1200 E Ste 104 Lehi, UT , TTY: 711

46 Long-term care pharmacies near you Smith Drug Co 10 S Main St Pleasant Grove, UT , TTY: 711 Stapley Pharmacy 102 E City Center St George, UT , TTY: 711 Washington Omnicare of St. George 595 S Bluff St Ste 3 St George, UT , TTY: 711 Weber Care First Pharmacy, LLC 5492 S Adams Ave Washington Terrace, UT , TTY: 711 Indian health service/tribal/urban Indian health program (I/T/U) pharmacies near you Only Native Americans and Alaska Natives can use I/T/U pharmacies in the plan s pharmacy network. Other people may be able to use these pharmacies under limited circumstances (for example, emergencies). For more information, please see your Evidence of Coverage. Below are some of the I/T/U network pharmacies in your area. San Juan Monument Valley Health Center 30 West Medical Drive Monument Valley, UT , TTY: 711 Uintah Unitah & Ouray Health Center 6822 E 1000 South Fort Duchesne, UT , TTY: 711

47 This directory is a partial list of pharmacies available in the plan s pharmacy network. For more information, please call Customer Service at: Toll-Free , TTY a.m. to 8 p.m. local time, Monday through Friday 1 Other pharmacies are available in our network. Members may use any pharmacy in the network, but may not receive Pharmacy Saver pricing. Pharmacies participating in the Pharmacy Saver program may not be available in all areas. 2 Your plan sponsor may provide coverage beyond 90 days. Please refer to the Evidence of Coverage for more information. This information is available for free in other languages. Please call our Customer Service number listed above. Esta información está disponible sin costo en otros idiomas. Comuníquese con el Servicio al Cliente al número indicado arriba. OptumRx is an affiliate of UnitedHealthcare Insurance Company. Beneficiaries must use network pharmacies to access their prescription drug benefit. Formulary, pharmacy network, premium and/or co-payments/coinsurance may change each year. NOTE: If you are receiving Extra Help from Medicare, your co-pays may be lower or you may have no co-pays. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan s contract renewal with Medicare. UHEX15MP _000 Last updated October 2014