Find a pharmacy

Network pharmacies are pharmacies that have agreed to fill prescriptions for our SCFHP DualConnect 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. For a list of exceptions, see the ‘Out-of-network pharmacies’ section below.

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 DualConnect 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, refer to the SCFHP DualConnect Member Handbook, Chapter 7, Section A, or Chapter 5, Section A. You can find the SCFHP DualConnect Plan 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 DualConnect 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 provider for an emergency prescription and take the prescription to any local network pharmacy. The pharmacy may contact SCFHP DualConnect to get an emergency override due to the delay in the mail-order process.

How will the mail-order service process my prescription?

1. New prescriptions the pharmacy gets from you
   The pharmacy automatically fills and delivers new prescriptions it gets from you.
2. New prescriptions the pharmacy gets from your provider’s office
   After the pharmacy gets a prescription from a healthcare provider, they will contact you to find out if you want the medication filled immediately or at a later time. This gives you an opportunity to make sure the pharmacy is delivering the correct drug (including strength, amount, and form) and, if needed, allows you to stop or delay the order before it is shipped. Respond each time the pharmacy contacts you, to let them know what to do with the new prescription and to prevent any delays in shipping.
3. Refills on mail-order prescriptions
   For refills, contact your pharmacy 10 days before your current prescription will run out to make sure your next order is shipped to you in time. If you have difficulty and need assistance, please contact your care coordinator at 1-877-590-8999 (TTY: 711), Monday through Friday, 8:30 a.m. to 5 p.

To contact SCFHP DualConnect mail-order pharmacy:

Write to:

MedImpact Direct
PO Box 51580
Phoenix, AZ 85076-1580

Call: 1-855-873-8739 (TTY: 711)

Hours:
Monday through Friday, 5 a.m. to 5 p.m.
Saturday, 5 a.m. to 1 p.m.
Sunday, Closed

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 DualConnect Provider and Pharmacy Directory in the mail, please click here to submit an online request, or call SCFHP DualConnect Customer Service at 1-877-723-4795 (TTY: 711), 7 days a week, 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 DualConnect 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 DualConnect Provider and Pharmacy Directory was printed. If you have questions regarding pharmacy locations, call SCFHP DualConnect Customer Service at 1-877-723-4795 (TTY: 711), 7 days a week, 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 DualConnect Customer Service for help.

If you are more comfortable speaking a language other than English, SCFHP can help you. Whether you are contacting SCFHP or visiting a doctor, we have interpreters available. Tell your doctor you would like an interpreter for your visit.

Know your rights

• You can get an in-person or telephone interpreter at no cost to you. This includes American Sign Language.
• When you go to the doctor, interpreters are available 24-hours a day.
• You can ask for SCFHP DualConnect materials written in other languages.

How can you get an interpreter?

Tell your doctor’s office you would like one. You can do this when you call to set up your next visit. You can also ask us for an interpreter or for translated materials.