Pharmacy Network

Our network gives you choices for when and how you order prescription drugs. We contract with hundreds of pharmacies in Oregon and pharmacies throughout the U.S. Our network includes retail pharmacies, home infusion, long-term care, Indian health service pharmacies, and specialty and mail-order pharmacies. And, for your convenience, you can fill up to a 93-day supply of maintenance medications at your local retail pharmacy.

Some of our network pharmacies provide preferred cost sharing, which may be lower than the cost sharing at a pharmacy that offers standard cost sharing. The Pharmacy Directory will tell you which of the network pharmacies offer preferred cost sharing. Contact us to find out more about how your out-of-pocket costs could vary for different drugs.

Use our online directory to find a pharmacy in our network. You can request a printed directory by emailing PharmacyMedicare@modahealth.com. You can also download a pharmacy directory below.

Pharmacy Directory

• 2024 Moda Health Medicare Pharmacy Directory

Out-of-network coverage

We cover prescriptions from in-network pharmacies. Unless you are in one of the circumstances we list below, we cannot cover prescriptions from out-of-network pharmacies. Circumstances for out-of-network prescription coverage:

• Medical emergencies
• If a pharmacy that is open 24 hours is not within a reasonable driving distance
• You cannot get the prescription you need because an in-network pharmacy does not have it in stock
• You are traveling outside your plan service area and run out of or lose your covered Part D drugs
• You become ill and need a covered Part D drug, and cannot access a network pharmacy

In these circumstances, we can fill up to a 31-day supply. If you are in one of these circumstances, please call us before you fill your prescription. We can see if there is a network pharmacy in your area.

Please call our Moda Health Pharmacy Customer Service at 503-265-4709 or toll-free at 888-786-7509. TTY users, dial 711. Pharmacy Customer Service is available from 7 a.m. to 8 p.m., Pacific Time, seven days a week from October 1 through March 31. (After March 31, your call will be handled by our automated phone system Saturdays, Sundays and holidays.)

If you do go to an out-of-network pharmacy, you may have to pay the full cost of the drug instead of just your copayment or coinsurance. You also may pay more for your prescription. You can ask us to reimburse you for this prescription by submitting a claim.

Pharmacy Customer Service

Please call our Moda Health Pharmacy Customer Service at 503-265-4709 or toll-free at 888-786-7509. TTY users, dial 711. Pharmacy Customer Service is available from 7 a.m. to 8 p.m., Pacific Time, seven days a week from October 1 through March 31. (After March 31, your call will be handled by our automated phone system Saturdays, Sundays and holidays.)