A Pharmacy Near You
KelseyCare Advantage has contracted with Prescription Solutions, a pharmacy benefits administrator, to provide you with access to a broad pharmacy network, prescription savings and benefit administration. When you choose KelseyCare Advantage Rx or KelseyCare Advantage Rx+Choice, you will have access to more than 900 retail pharmacies within the KelseyCare Advantage service area.
Click here to download a copy of our Pharmacy Directory or search our online directory.
Quick Answers
Where can I get my prescriptions filled?
KelseyCare Advantage has formed a network of preferred and non-preferred pharmacies. You must use a network pharmacy to receive KelseyCare Advantage benefits. We may not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases.
Click here for the Member Prescription Drug Direct Reimbursement Claim Form.
What is a preferred pharmacy?
Preferred pharmacies are pharmacies in our network in which our plan has negotiated lower cost-sharing for its plan members for covered prescription drugs than at non-preferred pharmacies. However, you will still have access to lower drug prices at non-preferred pharmacies than at out-of-network pharmacies. You may go to either of these types of network pharmacies to receive your covered prescription drugs.
Click here to download a copy of our Pharmacy Directory or search our online directory.
The pharmacies in our network can change at any time. To verify if a pharmacy is part of our network, please call a KelseyCare Advantage health plan specialist at:
713-442-CARE (2273) or
Prescription Solutions
Toll free 1-888-242-1009
TTY/TDD 1-866-394-7218
What is a prescription drug formulary?
A formulary is a list of drugs covered by your plan to meet patient needs. The drugs on our formulary are selected by a KelseyCare Advantage healthcare team of experts to provide prescription drug therapies that are believed to be a necessary part of a quality treatment program. We may periodically add, remove or make changes to coverage limitations on certain drugs or change how much our members’ pay for a drug. If we make any formulary changes that limits our members’ ability to fill their prescriptions, we will notify the affected members before the change is made.
If you are currently taking a drug that is not on our formulary or is subject to additional requirements or limits, you may be able to get a temporary supply of the drug within your first 90 days of coverage with our plan. You can contact us to request an exception or switch to an alternative drug listed on our formulary with your physician’s help. Call us to see if you can get a temporary supply of the drug or for more details about our drug transition policy:
713-442-CARE (2273) or
Prescription Solutions
Toll free 1-888-242-1009
TTY/TDD 1-866-394-7218
How can I get extra help with my prescription drug plan costs?
If you have limited income and resources, you may qualify for extra help to pay your Medicare prescription drug costs. For more information about applying for extra help, call 1-800-633-4227 24 hours a day, 7 days a week. (TTY/TDD 1-877-486-2048).
