Questions? Contact Customer Service at (855) 645-8448
In most cases, your prescription drugs are filled at Memorial Hermann Advantage's network of pharmacies. A network pharmacy is a pharmacy that has a contract with the plan to provide your covered Medicare Part D prescription drugs. In most cases, your prescriptions are covered under your plan only if they are filled at a network pharmacy or through the Costco Mail Order pharmacy service. You may switch to any network pharmacy to fill your prescriptions. Prescriptions can be filled at non-network pharmacies under certain circumstances as described in your Evidence of Coverage (EOC). The pharmacy network may change at any time and in some circumstances, you may be notified. To verify if a pharmacy is part of our network, please contact Customer Service at (844) 860-6750 (TTY 711). You can also download a copy of our Pharmacy Directory or visit our website's online pharmacy search tool.
Please note that due to possible changes that can occur after our Pharmacy Directory is updated, inclusion of a pharmacy in this directory does not guarantee the pharmacy is still in the network at the time of use. It also does not guarantee that the pharmacy is open or is at the same location as listed in the directory. Please reach out to your pharmacy for the most up-to-date information on their location and hours of operations. You may also contact our Customer Service for additional assistance.
There are two options available to you through Costco Mail Order Pharmacy: traditional mail order or online enrollment. For more information on the Costco Mail Order Pharmacy and for ordering instructions, please click here.
To obtain prescription drugs by mail, use the following mail-order form or call Costco Mail Order Pharmacy Member Services at (800) 607-6861 (TTY 711), 7 a.m. to 9 p.m. CT, Monday - Friday, 11:30 a.m. to 4 p.m. CT, Saturday – Sunday. Prescription drugs that you get through any other mail order service are not covered.
You can use the mail order service to fill prescriptions for many drugs that are on the formulary list. When you order prescription drugs by mail, you may order up to a 90-day supply of the drug.
For more information on home delivery (mail order) information, please also visit the Costco Mail Order Information section on our Pharmacy FAQ page.
For instructions on how to enroll for prescriptions online with Costco Mail Order, click here.
Memorial Hermann Advantage HMO plan network has both preferred and standard pharmacies listed in our pharmacy directory. Pharmacies listed in our directory with a “P” indicates pharmacies who are preferred by our plan and you can usually save money by paying a lower copay or coinsurance when filling at these pharmacies. Some examples of preferred pharmacies includes: CVS Pharmacy, HEB Pharmacies, Memorial Hermann pharmacies, Walmart, and more! Check the pharmacy directory for a full list of preferred pharmacies. Please use the online directory and check the last updated date at the bottom of the directory to ensure you are using the latest updated listing.
Please see the service areas for our individual plans below:
Generally, we cover drugs filled at an out-of-network pharmacy only when you are not able to use a network pharmacy. To ensure that Memorial Hermann Advantage will allow an out-of-network pharmacy before you fill your prescription, call Customer Service to see if there is a network pharmacy in your area where you can fill your prescription.
If you go to an out-of-network pharmacy due to a health emergency, you may have to pay the full cost (rather than paying just your co-pay) when you fill your prescription. In the event of using an out-of-network pharmacy for an emergency, you can ask us to reimburse you for our share of the cost by submitting a paper claim form called a Direct Member Reimbursement (DMR), Spanish DMR form is available here.
However, even after we reimburse you for our share of the cost, you may pay more for a drug purchased at an out-of-network pharmacy because the out-of-network pharmacy’s price may be higher than a network pharmacy’s. Regardless of the amount, we can only reimburse you the amount that we would have paid if you had the prescription filled at a network pharmacy. Even though you may not receive the full amount you paid in reimbursement, the amount that you paid may still be counted toward your required out-of-pocket costs in reaching the catastrophic stage.