Exhibit_A,_Attachment_A.2_-_Medicare_Part_D_Pharmacy_List.xlsx
XLSX spreadsheet 26 KB Posted
- Solicitation number
- 26-P-67TF
- Issued by
- Volusia County, Florida
About this file
This is a Medicare Part D Pharmacy Network List attachment for Volusia County, Florida's Medicare Supplement and Part D Pharmacy Insurance contract opportunity. The document requires contractors to identify their in-network pharmacy providers by marking an "X" in the designated column for each pharmacy included in their network. The list includes ten major pharmacy providers: Costco Pharmacy, CVS Pharmacy, Daytona Discount Pharmacy, Guardian Pharmacy, Medicine Shoppe, Publix Pharmacy, Sam's Club Pharmacy, Target Pharmacy, Walmart Pharmacy, and Walgreens Pharmacy. Contractors must provide a minimum network of these pharmacy providers for the plan effective January 1, 2027, which covers Medicare-eligible retirees and their eligible dependents from Volusia County government and participating agencies. The contractor must maintain separate eligibility reporting by agency and coordinate with the current Third Party Administrator, WEX, for eligibility, enrollment, and billing management.
The file specifies plan configuration options including HMO, PPO/EPO/POS, and Fee for Service Supplement plans with varying prescription drug coverage categories. Drug coverage is categorized as generic drugs with no exclusions, brand preferred and brand non-preferred prescription drugs, specialty drugs, and non-covered drugs, with options for plans with high deductibles. The pharmacy network structure supports a Part D prescription drug plan component, with the ability to accommodate Major Chains limited networks or enhanced network options depending on the selected plan type.
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Text version
Pharmacy Legal Company Name
Instructions:
1. Contractor shall provide, at a minimum, the following pharmacy providers in the network for the Plan.
2. Provide your Legal Company Name at the top of this sheet.
3. Place an X in the "In-Network" column beside each pharmacy provider that is in your network for the Plan. Leave the field blank if the provider is not in your network. Do Not Re-sort.
| Pharmacy | In Network |
| COSTCO PHARMACY | |
| CVS PHARMACY | |
| DAYTONA DISCOUNT PHARMACY | |
| GUARDIAN PHARMACY | |
| MEDICINE SHOPPE | |
| PUBLIX PHARMACY | |
| SAM'S CLUB PHARMACY | |
| TARGET PHARMACY | |
| WALMART PHARMACY | |
| WALGREENS PHARMACY |
&"Arial,Bold"&12 26-P-67TF Attachment A.2 - Medicare Part D Pharmacy List
COUNTY OF VOLUSIA - MEDICAL AND PHARMACY PLAN FOR MEDICARE ELIGIBLE RETIREES
PHARMACIES
drop down box
| Drug Plan Type | PCP Required | RX Network | Medical Plan Type |
| Partial Part D | Yes | Major Chains | HMO |
| 100% Part D | No | Limited Network | PPO/EPO/POS |
| Part D Enhanced | Fee for Service | ||
| Supplement plans | Drug list | OOP Exclusions | Medicare Part B Drugs |
| A | Generic | None | Covered under Medical |
| B | Brand Preferred | Prescription Drugs | Covered under Pharmacy |
| C | Brand Non-preferred | ||
| D | Specialty | ||
| F | Not Covered | ||
| F with a high deductible | |||
| G | |||
| K | |||
| L | |||
| M | |||
| N |
File details come from the government source that posted it. Updated .