Pharmacy Services

How do I get my prescriptions filled?

If you have a prescription that needs to be filled, you should take it to one of the pharmacies on the pharmacy list that PHC sent you. If you do not have the copy we sent you, you can get a copy of our contracted pharmacies from the section of this web site titled "provider directories" or you can call the PHC Member Services Department.

There is a $5.00 co-payment per prescription. Generic Drugs are used unless there is not generic equivalent for a brand name drug, of unless there is a medical reason for you to have to take a brand name drug instead of the generic equivalent.

 

Getting your prescription filled

You should never have to pay for a prescription that is covered and medically necessary. If you are having a problem getting a prescription or you had to pay for a prescription, you should call our Member Services Department right away. Our phone number is (800) 863-4155.

PHC only covers brand name drugs when a generic equivalent drug is not available. However, if there is a medical reason why a generic drug may not be used, a request for authorization must be submitted to PHC indicating the medical reason.

Below are some tips on getting prescriptions filled more quickly and easily:

        • Always present all of your health insurance cards, including your PHC ID card and your Medi-Cal card.
        • Find a pharmacy that you like and when possible get your prescriptions filled there.
        • Listen and follow the pharmacist's instructions about how often you should take your medicine.
        • Call ahead to your pharmacy when you need a refill. Don't wait until you run out of medicine. You should call when 75% of your prescription is gone.

If you have a problem getting your prescription filled, you should:

        • Ask to speak to the head pharmacist or pharmacy manager.
        • Call our PHC Members Services Department at (800) 863-4155.

Pharmacy Services 

PHC keeps a list of drugs called a "Drug Formulary." PHC's Pharmacy and Therapeutics Committee meets quarterly to review and revise the formulary. Drugs are evaluated and selected for the formulary based on safety, quality, effectiveness and affordability. In some cases your doctor may choose to prescribe a drug that is not on the formulary. In order for this drug to be covered, your doctor must obtain approval form PHC before your prescription is filled.
If you would like a copy of the PHC's Drug Formulary, you can contact the PHC's Member Services Department. The formulary is also available on the web site.

 

Click here for the PHC Drug Formulary

 

Pharmacy – Mail Order Services

PHC has contracted with Walgreen's Mail Order Service Pharmacy to provide a mail order service for maintenance medications and for PHC members. This is a great service that is FREE and will save you many unnecessary trips to the pharmacy.


For more information about this free service, please call our Member Services Department at 800 863-4155.