Find a pharmacy
Santa Clara Family Health Plan (SCFHP) Cal MediConnect Plan (Medicare-Medicaid Plan) (SCFHP Cal MediConnect) contracts with most chain and independent pharmacies in Santa Clara County. To fill your prescription, show your SCFHP Cal MediConnect member ID card and your doctor’s prescription to any pharmacy in our network.
Network pharmacies are pharmacies that have agreed to fill prescriptions for our SCFHP Cal MediConnect members. You can fill your prescription at more than 200 network pharmacies.
Network pharmacies include:
- Retail and chain pharmacies
- Mail-order pharmacies
- Home infusion pharmacies
- Long-term care pharmacies
You are not required to continue going to the same pharmacy to fill your prescriptions. However, you must fill your prescriptions at one of our network pharmacies if you want SCFHP to cover them. Emergencies and urgent care situations are the only exception.
Generally, we pay for drugs filled at an out-of-network pharmacy only when you are not able to use an in-network pharmacy. We have network pharmacies outside of our service area where you can get your prescriptions filled as a member of our plan.
We will pay for prescriptions filled at an out-of-network pharmacy in the following cases:
- When filling a specialized drug that is otherwise not available at a network pharmacy
- When filling a drug that has limited distribution source
- When filling a drug in an emergency situation when network pharmacies are not available, such as emergency illness while traveling or during a declared disaster
In these cases, please check first with SCFHP Cal MediConnect Customer Service to see if there is a network pharmacy nearby.
You must use network pharmacies except in emergency or urgent care situations. If you go to an out-of-network pharmacy for prescriptions when it is not an emergency, you will have to pay out-of-pocket costs. For reimbursement on prescriptions you pay for, see the SCFHP Cal MediConnect Member Handbook, Chapter 7, Section A, or Chapter 5, Section A. You can find the SCFHP Cal MediConnect Member Handbook in Member Materials.
For certain kinds of drugs, you can use the plan’s network mail-order services. Generally, the drugs available through mail-order are drugs that you take on a regular basis for a chronic or long-term medical condition. Certain medications, such as controlled substances with a high potential for addiction or abuse are not available through mail-order. Our mail-order service allows you to fill up to a 90-day supply. A 90-day supply has the same copay as a one-month supply.
How do I fill my prescriptions by mail?
To get order forms and information about filling your prescriptions by mail, call SCFHP Cal MediConnect Customer Service or go to www.medimpactdirect.com. If you use a mail-order pharmacy that is not in the plan’s network, your prescription will not be covered. Usually, a mail-order prescription will get to you within 10 calendar days. However, sometimes your mail-order may be delayed. If delivery is delayed or you are requesting an urgently needed medication, you may contact your PCP for an emergency prescription and take the prescription to any network pharmacy. The pharmacy may contact SCFHP Cal MediConnect to get an emergency override due to the delay in the mail-order process.
How will the mail-order service process my prescription?
- New prescriptions the pharmacy receives from you
The pharmacy will fill and deliver new prescriptions it receives from you.
- New prescriptions the pharmacy receives directly from your provider’s office
After the pharmacy receives a prescription from your prescriber, they will contact you to see if you want the medication filled right away or at a later time. This will give you a chance to make sure the pharmacy is delivering the right drug to the right place. This also allows you to stop or delay the order before it is shipped. It is important that you respond each time you are contacted by the pharmacy to let them know what to do with the new prescription and to prevent any delays in shipping.
- Refills on mail-order prescriptions
For refills, please contact your pharmacy 10 days before you think the drugs you have on hand will run out. This is to make sure your next order is shipped to you in time.
How do I contact the mail-order pharmacy?
To contact SCFHP Cal MediConnect mail-order pharmacy:
PO Box 51580
Phoenix, AZ 85076-1580
Call: 1-855-873-8739 (TTY: 711)
Monday through Friday, 5 a.m. to 5 p.m.
Saturday, 6 a.m. to 2 p.m.
See answers to frequently asked questions about mail-order pharmacy on MedImpact Direct's website at www.medimpactdirect.com/FAQ.
To request a hard copy of the SCFHP Cal MediConnect Provider and Pharmacy Directory in the mail, please click here to submit an online request, or call SCFHP Cal MediConnect Customer Service at 1-877-723-4795 (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m.
You can make a standing request to get this document in a language other than English or in an alternate format. We will keep this information on file for future mailings. You do not need to make a separate request each time. To make or change your request, call SCFHP Cal MediConnect Customer Service, submit an online request, or send a request in writing to:
Attn: Customer Service Department
Santa Clara Family Health Plan
PO Box 18880
San Jose, CA 95158
Please note that network pharmacies may have been added or removed after the SCFHP Cal MediConnect Provider and Pharmacy Directory was printed. If you have questions regarding pharmacy locations, call SCFHP Cal MediConnect Customer Service at 1-877-723-4795 (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m.
You can ask for published materials for free in other formats, such as large print, Braille, or audio. Call SCFHP Cal MediConnect Customer Service for help.
If you speak a language other than English, language assistance services, free of charge, are available to you. Call SCFHP Cal MediConnect Customer Service at 1-877-723-4795 (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m. The call is free.