HealthSpring Pharmacy Networks

Out-of-Network Pharmacies

In general, we will cover drugs filled at an out-of-network pharmacy only when you are not able to use a network pharmacy. Here are some of the events when we would cover prescriptions filled at an out-of-network pharmacy:

• You travel outside the plan’s service area and run out of or lose covered Part D drugs or become ill and need a covered Part D drug and cannot get to a network pharmacy.
• You cannot get a covered Part D drug quickly within the service area. This may be because there is no network pharmacy within driving distance that offers 24-hour service.
• You are filling a prescription for a covered Part D drug and that type of drug is not often stocked at an accessible network retail or mail-order pharmacy.
• Part D drugs are dispensed by an out-of-network, institution-based pharmacy while in an emergency facility, provider-based clinic, outpatient surgery or other outpatient setting.

In these situations, please check first with Customer Service to see if there is a network pharmacy nearby.

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¹ Preferred network pharmacy savings do not apply to all plans.

² Potential home delivery copay savings will vary based on plan and medication drug tier.