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Providence Medicare Plans (Medicare Part D) Pharmacy Resources
Search for nationwide pharmacy providers available through Providence Health Plans.
Search Pharmacy Provider Directory
View your specific plan pharmacy benefits for details.
Formulary (Drug List) and Directory
Please review the Formulary for the copay or coinsurance amount for each drug.
- 2009 Medicare Drug Formulary (PDF 651kb)
- 2009 Prior Authorization Criteria
- 2008 Medicare Drug Formulary (PDF 1.1MB)
- 2008 Pharmacy Provider Directory (PDF 5.8MB)
- Effective Generic Options for Expensive Brand Prescriptions (PDF 81kb)
- Best Available Evidence - Centers for Medicare & Medicaid Services Web site
Pharmacy FAQs
- Can the formulary change?
- How to I find an in-network pharmacy in my area?
- Filling prescriptions outside of the network
- Member Pharmacy Transition Process
- Medication Therapy Management Program
For more information contact the Providence Medicare Plans Sales Team.
Coverage Determination/Appeals and Grievances
- Coverage Determination, Formulary Exceptions
- Appeals and Grievances
- Appointment of Representative Form (PDF 90kb)
If you would prefer that someone else act on your behalf, please fill out this form, sign it and return it to us.- In writing, to Providence Medicare Plans, Attn: Appeals and Grievance Department P.O. Box 4327 Portland, OR 97208-4327.
- By fax, at 1-800-396-4778.
- By telephone – if it is a fast appeal – at 503-574-8000 or 1-800-603-2340.
- In person, at Providence Health Plan Attn: Appeals and Grievance Department 3601 SW Murray Blvd., Suite 10 Beaverton, OR 97005.
You can contact customer service if you need additional information, including:
- How we control the use of services and costs;
- The number of appeals and grievances filed by our members;
- A summary description of how we pay our doctors; or
- A description of our financial condition, including a summary of our most recent audit statement.
Participating Mail Order Pharmacies
Preferred Participating Mail Order Pharmacies
Providence Health Plan is a health plan with a Medicare Advantage contract.
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