I NDEPENDENT HE ALTH ’ S

2016Medicare AdvantagePharmacy Directory

For more information, please contact Independent Health’s Member Services at 1-800-665-1502 (TTY users call 1-800-432-1110), October 1 – February 14: Monday – Sunday, 8 a.m. – 8 p.m.;February 15 – September 30: Monday – Friday, 8 a.m. – 8 p.m. Or visit independenthealth.com. This pharmacy directory was updated on January 13, 2016.

Independent Health’s Medicare Advantage Plan 2016 Pharmacy Directory

This pharmacy directory was updated on January 13, 2016. For more recent information or other questions, please contact Independent Health’s Medicare Member Services Department at 1-800-665-1502or, for TTY users, 1-800-432-1110, October 1 – February 14: Monday – Sunday from 8 a.m. – 8 p.m.,February 15 – September 30: Monday – Friday from 8 a.m.– 8 p.m., or visitwww.independenthealth.com/Medicare.

Independent Health is a Medicare Advantage Organization with a Medicare contract offering HMO, HMO-SNP, HMO-POS, and PPO plans. Enrollment in Independent Health depends on contract renewal.

The pharmacy network may change at any time. You will receive notice when necessary.

If you need help finding a network provider and/or pharmacy, please call Independent Health’s MedicareMember Services Department at (716) 250-4401 or 1-800-665-1502 (TTY users call 1-800-432-1110):October 1 – February 14: Monday – Sunday, 8 a.m. – 8 p.m. and February 15 – September 30: Monday – Friday, 8 a.m. – 8 p.m. or visit www.independenthealth.com/Medicare to access our online directory. If you would like a Provider/Pharmacy Directory mailed to you, you may call the number above,request one at the website link provided above, or email memberservice@servicing.independenthealth.com.

Verbal translation of written materials is available via free interpreter services. For those with special needs,accessibility to benefit information or alternate formats of written materials are available upon request.

Y0042_PH349 Accepted 09132015

INTRODUCTION

This booklet provides a list of Independent Health’s network pharmacies. To get a complete description ofyour prescription coverage, including how to fill your prescriptions, please review the Evidence of Coverageand Independent Health’s Medicare Advantage Plan formulary.

When this pharmacy directory refers to “we,” “us” or “our,” it means Independent Health. When it refers to“plan” or “our plan,” it means Independent Health’s Medicare Advantage Plan.

We call the pharmacies on this list our “network pharmacies” because we have made arrangements withthem to provide prescription drugs to Plan members. In most cases, your prescriptions are covered underIndependent Health only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fillyour prescription but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage.

All network pharmacies may not be listed in this directory. Pharmacies may have been added or removedfrom the list after this directory was printed. This means the pharmacies listed here may no longer be in ournetwork, or there may be newer pharmacies in our network that are not listed. This list is current as ofJanuary 13, 2016. For the most current list, please contact us. Our contact information appears on thefront and back cover pages.

Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory islocated on our website at www.independenthealth.com/Medicare. You may also call Member Services forupdated provider information.

You can get prescription drugs shipped to your home through our network mail order delivery service. For more information, please contact us or see the mail order section of this pharmacy directory.

If you have questions about any of the above, including instructions on how to submit claims for prescriptions that you had to fill at a non-network pharmacy, please see the first and last cover pages of thisdirectory for information on how to contact Independent Health.

SECTION OVERVIEW:

Retail Pharmacies ..............................................................................................................................................................04

Mail Order Pharmacies..................................................................................................................................................08

Home Infusion Pharmacies..........................................................................................................................................08

Long-Term Care Pharmacies ......................................................................................................................................09

Indian Health Services/Tribal/Urban Indian Health Program (I/T/U) Pharmacies...................10

Specialty Pharmacies .......................................................................................................................................................10

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RETAIL PHARMACIESAll of the network pharmacies listed currently offer a 90-day supply of maintenance medications. For all of our retailpharmacies, including chains TTYusers may call the national TTYrelay service number: 711.CVS www.cvs.com/pharmacy1-888-607-4287Kmartpharmacy.kmart.com1-800-349-0764Rite Aid www.riteaid.com/pharmacy1-800-748-3243Sams Club www.samsclub.com1-888-746-7726Targetwww.target.com/pharmacy1-877-798-2743Tops Marketswww.topsmarkets.com/Departments/Pharmacy1-800-522-2522Walgreenswww.walgreens.com/pharmacy1–800–925–4733Wal-Martwww.walmart.com/pharmacy1-800-925-6278Wegmans Food Marketswww.wegmans.com/pharmacy1-800-848-1555

ALLEGANY COUNTYAlfred Pharmacy, Inc. 36 N. Main St. Alfred, NY 14802 (607) 587-9222Cuba Pharmacy 2 Center St. Cuba, NY 14727 (585) 968-3111Fillmore and Fisher Pharmacy, Inc.10560 Rte. 19 Fillmore, NY 14735 (585) 567-2228

Fisher Pharmacy 138 N. Main St. Wellsville, NY 14895 (716) 593-2611Friendship Pharmacy9 W. Main St. Friendship, NY 14739 (585) 973-3496Nicholson Pharmacy, Inc. 36 Schuyler St. Belmont, NY 14813 (585) 268-7287

CATTARAUGUS COUNTYBartholomews Pharmacy 2 Elm St. Franklinville, NY 14737 (716) 676-3350

Corner Drug Store1 Washington St. Cattaraugus, NY 14719 (716) 257-374Dan Horn Pharmacy and Health Svces. 111 E. Green St. Olean, NY 14760 (716) 376-6337Ellicottville Pharmacy, Inc. 6133 Rte. 219, Ste. 1004 Ellicottville, NY 14731 (716) 699-2300Inkley Pharmacy 113 Main St. Randolph, NY 14772 (716) 358-3201Prizels Pharmacy 535 Main St. Olean, NY 14760 (716) 373-8383South Dayton Pharmacy 303 Pine Street S.Dayton, NY 14138 (716) 988-3410Valley Pharmacy and MedicalSupplies, Inc.31 W. Main St. Gowanda, NY 14070 (716) 532-1700Vic Vena Pharmacy 1322 W. State St. Olean, NY 14760 (716) 372-7761

CHAUTAUQUA COUNTYConcord Pharmacy 10220 Rte. 60 Fredonia, NY 14063 (716) 672-8400Falconer Pharmacy, Inc.202 W. Main St. Falconer, NY 14733 (716) 665-1188Frewsburg Pharmacy 26 W. Main St. Frewsburg, NY 14738 (716) 569-2221Johnsons Village Pharmacy, Inc. 99 E. Chautauqua St., Ste. 3 Mayville, NY 14757 (716) 753-3200Lakewood Apoth NaturalHealth Care, Inc. 130 Chautauqua Ave. Lakewood, NY 14750 (716) 763-0016Patient’s Pharmacy and Medical 436 Central Ave. Dunkirk, NY 14048 (716) 363-6339Pharmacy Innovations863 Fairmount Ave. Jamestown, NY 14701 (716) 484-1586Sherman Pharmacy, Inc. 105 W. Main St. Sherman, NY 14781 (716) 761-6876Southside Pharmacy 766 Foote Ave.Jamestown, NY 14701 (716) 487-0133

ERIE COUNTYAkron Pharmacy 58 Main St. Akron, NY 14001 (716) 542-6300Alden Pharmacy, Inc. 13203 Broadway St. Alden, NY 14004 (716) 937-9818AnthoNY Brown Pharmacy 4328 S. Buffalo St. Orchard Park, NY 14127 (716) 662-3800

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Blackrock Pharmacy 431 Tonawanda St. Buffalo, NY 14207 (716) 876-3070Brighton Pharmacy 935 Brighton Rd. Tonawanda, NY 14150 (716) 835-6778Brooks Pharmacy 4481 Lake Shore Rd. Hamburg, NY 14075 (716) 627-3060Buffalo Pharmacies, Inc. 1479 Kensington Ave.Buffalo, NY 14215 (716) 832-0599

6035 Transit Rd. East Amherst, NY 14051 (716) 568-1370Care More Pharmacy LLC.319 Ridge Rd. Lackawanna, NY 14218 (716) 235-8185Casey's Prescription Pad, Inc.4154 Mckinley Parkway, Ste. 400 Blasdell, NY 14219 (716) 926-9044Children’s Homecare Pharmacy 219 Bryant St. Buffalo, NY 14222 (716) 878-7990Cys Elma Pharmacy 2317 Bowen Rd. Elma, NY 14059 (716) 652-3920Dexter Drugs Ctr. 1453 Jefferson Ave. Buffalo, NY 14208 (716) 885-7878Family Medical Pharmacy, Inc. 120 Plaza Dr. Williamsville, NY 14221 (716) 568-0800Forsters Pharmacy, Inc.3713 S. Park Ave. Blasdell, NY 14219 (716) 823-9800Grant Street Pharmacy 85 Grant St. Buffalo, NY 14213 (716) 885-5554

Guardian Pharmacy, LLC3980 Sheridan Dr., Ste. 304Amherst, NY 14226(716) 768-5615

Hamburg Pharmacy, Inc. 206 Lake St. Hamburg, NY 14075 (716) 646-3147High Street Prescription Center 100 High St. Buffalo, NY 14203 (716) 859-1570Holland Pharmacy, Inc. 19 Main St. Holland, NY 14080 (716) 537-2822Island Prescription Center 1728 Grand Island Blvd. Grand Island, NY 14072 (716) 773-5599Ivylea Pharmacy 2446 Elmwood Ave. Kenmore, NY 14217 (716) 873-1444Kenmore Rx Center 2818 Delaware Ave. Kenmore, NY 14217 (716) 874-6360Larwood Pharmacy, Inc. 597 Oakwood Ave.East Aurora, NY 14052 (716) 652-1360Lifetime Health Medical Group 1185 Sweet Home Rd.Amherst, NY 14226 (716) 689-3471

899 Main St. Buffalo, NY 14203 (716) 878-2700

151 Elmview Ave. Hamburg, NY 14075 (716) 648-3040Medical Park Pharmacy, Inc. 550 Orchard Park Rd. West Seneca, NY 14224 (716) 677-6400Medicine Shoppe 1931 2156 Grand Island Blvd. Grand Island, NY 14072 (716) 773-3111

Medicine Shoppe 1988 2032 Clinton St. Buffalo, NY 14206 (716) 824-5200Medicine Shoppe 1989 1791 S. Park Ave. Buffalo, NY 14220 (716) 823-8300Medicine Shoppe 1990 1979 Seneca St. Buffalo, NY 14210 (716) 827-4900Medicine Shoppe 1991 3038 Bailey Ave. Buffalo, NY 14215 (716) 822-4400Metcare462 Grider St., Driveway 3 Buffalo, NY 14215 (716) 332-2866Metcare34 Benwood Ave. Buffalo, NY 14214 (716) 332-6811Mobile Pharmacy Solutions 644 Ellicott St., Ste. 104 Buffalo, NY 14203 (716) 247-5300Niagara Pharmacy 455 Niagara St. Buffalo, NY 14201 (716) 856-3610North Collins Pharmacy 10504 Main St. North Collins, NY 14111 (716) 337-2992Omnicare Pharmacy of Western New York 2410 North America Dr.West Seneca, NY 14224(716) 677-4845Parker Pharmacy 1388 Hertel Ave. Buffalo, NY 14216 (716) 725-0887Parkside Pharmacy, Inc. 975 Broadway St. Buffalo, NY 14212 (716) 895-8811Pharmacy @ Mattina300 Niagara St. Buffalo, NY 14201(716) 332-2288

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Pine Pharmacy 5110 Main St. Williamsville, NY 14221 (716) 332-2288Reliant Medical Pharmacy 4114 Union Rd., Ste. A Cheektowaga, NY 14225 (716) 817-5100

Sav-Rite Pharmacy1234 Abbott Rd.Lackawanna, NY 14218(716) 768-2500

Snyder Pharmacy, Inc. 4536 Main St. Snyder, NY 14226(716) 839-3050South Park Pharmacy 2707 South Park Ave. Lackawanna, NY 14218 (716) 823-0440Southgate Medical Pharmacy, Inc. 1026 Union Rd. West Seneca, NY 14224 (716) 712-0630Southtowns Medical Pharmacy, LCP 4855 Camp Rd., Ste. 600 Hamburg, NY 14075 (716) 649-1500Springcreek Pharmacy 227 W. Main St. Springville, NY 14141 (716) 592-9065Suburban Family Pharmacy 1540 Maple Rd. Williamsville, NY 14221(716) 568-3784The Medicine Shoppe 469 Niagara St. Buffalo, NY 14201 (716) 856-0800The Pharmacy at Evergreen 206 S. Elmwood Ave. Buffalo, NY 14201 (716) 541-0656Tile Pharmacy 1031 Cleveland Dr. Cheektowaga, NY 14225(716) 632-4888

Transit Hill Pharmacy 6344 Transit Rd. Depew, NY 14043 (716) 683-9444Union Medical Pharmacy 1769 Orchard Park Rd. West Seneca, NY 14224 (716) 675-4133Urgent Care Pharmacy, LLC 5965 Transit Rd. Clarence, NY 14051 (716) 362-1094Wanakah Pharmacy 4923 Lake Shore Rd. Hamburg, NY 14075 (716) 627-3232

GENESEE COUNTYAlberty Drugs 81 Main St. Batavia, NY 14020 (585) 344-1570Oakfield Family Pharmacy 40 Main St. Oakfield, NY 14125 (585) 948-5283United Memorial CommunityPharmacy 127 North St. Batavia, NY 14020 (585) 815-6736

NIAGARA COUNTYCommunity Medical Pharmacy, Inc. 918 Michigan Ave.Niagara Falls, NY 14305 (716) 282-1292Lockport Apothecary 6606 Lincoln Ave.Lockport, NY 14094 (716) 438-3990Macleods Pharmacy 8672 Buffalo Ave. Niagara Falls, NY 14304 (716) 283-8704Medicine Shoppe 1661 320 S. Transit St. Lockport, NY 14094 (716) 433-3733Medicine Shoppe 1992 2780 Main St. Newfane, NY 14108 (716) 778-0600

Middleport Family Health Ctr.81 Rochester Rd. Middleport, NY 14105 (716) 735-3261Niagara Apothecary 8745 Niagara Falls Blvd. Niagara Falls, NY 14304 (716) 297-3530Pendleton Star Pharmacy, Inc.6503 Campbell Blvd. Lockport, NY 14094 (716) 210-3152Pine Pharmacy 1806 Pine Ave. Niagara Falls, NY 14301 (716) 282-1112

Summit Park Pharmacy, Inc. 2578 Niagara Falls Blvd., Ste. 100 Niagara Falls, NY 14304 (716) 731-3500Wellness Park Pharmacy, Inc. 624 River Rd., Ste. 5a North Tonawanda, NY 14120 (716) 260-1918Wilson Community Pharmacy272 Pettit St. Wilson, NY 14172 (716) 751-0140Wurlitzer Family Pharmacy, Inc. 521 Division St. North Tonawanda, NY 14120 (716) 260-1131

ORLEANS COUNTYHolley Pharmacy 3 Geddes Street Ext. Holley, NY 14470 (585) 638-5499Medicine Shoppe 0463 142 E. Center St. Medina, NY 14103 (585) 798-1212Rosenkrans Pharmacy 526 Main St. Medina, NY 14103 (585) 798-1650

WYOMING COUNTYCottrills Pharmacy 255 Main St. Arcade, NY 14009 (585) 492-2310

Sinclair Pharmacy 75 N. Main St. Warsaw, NY 14569 (585) 786-2330Wyoming Drug 91 N. Main St. Warsaw, NY 14569 (585) 786-2100

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MAIL ORDER PHARMACIES

ProAct Pharmacy Services1-888-425-3301 (TTY: National 711 Relay Service)www.proactrx.com/mailWegmans Mail Order1-888-205-8573 (TTY: 1-877-409-8711)www.wegmans.com/pharmacy

You can get prescription drugs shipped to your home through our network mail order delivery service. For refills of your mail order prescriptions, you have the option to sign up for an automatic refill servicethrough ProAct Pharmacy Services and Wegmans Mail Order Pharmacy. Under this service, we will start toprocess your next refill automatically when our records show that you should be close to running out of yourdrug. We will contact you prior to shipping each refill to make sure you are in need of more medication. Youcan cancel scheduled refills if you have enough of your medication or if your medication has changed. If youchoose not to use the auto refill service, please contact us fourteen (14) days before you think the drugs youhave on hand will run out to make sure your next order is shipped to you in time. To opt out of the automatic refill service, please contact our Medicare Member Services Department at (716) 250-4401 or 1-800-665-1502, Monday through Sunday from 8 a.m. to 8 p.m. (October 1 – February 14) and Mondaythrough Friday from 8 a.m. to 8 p.m. (February 15 – September 30). TTY users may call 1-800-432-1110.Or, you may contact ProAct Pharmacy Services or Wegmans Mail Order Pharmacy at the contact information listed above.

Typically, you should expect to receive your prescription drugs within fourteen (14) business days from thetime that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) withinthis time, please contact us at (716) 250-4401 or 1-800-665-1502, Monday through Sunday from 8 a.m. to8 p.m. (October 1 – February 14) and Monday through Friday from 8 a.m. to 8 p.m. (February 15 –September 30). TTY users may call 1-800-432-1110.

HOME INFUSION PHARMACIES

If you have any questions about our home infusion pharmacies, please contact our Medicare MemberServices Department. Our contact information appears on the front and back cover pages.

For all of our home infusion pharmacies, TTY users may call the national TTY relay service number: 711.

ERIE COUNTYCatholic Health Infusion Pharmacy 6350 Transit Rd. , Depew, NY 14043 (716) 685-4870Coram CVS/Specialty Infusion Services375 N. French Rd., Ste. 108 , Amherst, NY 14228 (716) 691-3000Option Care40 Centre Dr., Orchard Park, NY 14127 (716) 667-7500VNA Home Care Services 2100 Wehrle Dr., Williamsville, NY 14221 (716) 630-8000

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LONG-TERM CARE PHARMACIES

Residents of a long-term care facility may access their prescription drugs covered under Independent Healththrough the facility’s long-term care pharmacy or another network long-term care pharmacy.

If you have any questions about our long-term care pharmacies, please contact our Medicare MemberServices Department. Our contact information appears on the front and back cover pages.

For all of our long-term care pharmacies, TTY users may call the national TTY relay service number: 711.

CHAUTAUQUA COUNTYHeritage Pharmacy 4600 Rte. 60 Sellew Bldg.Gerry, NY 14740 (716) 985-4649Patients Pharmacy, Inc. 320 N. Main St. Jamestown, NY 14701 (716) 483-6913The Care Center Pharmacy, Inc. 17 W. Lucas Ave. Dunkirk, NY 14048 (716) 366-0986The Resource Center Pharmacy 712 W. Eighth St. Jamestown, NY 14701 (716) 661-1520

ERIE COUNTY2121 Main Street Pharmacy 134 Bennett Rd. Cheektowaga, NY 14227 (716) 565-9775Buffalo Pharmacies Institutional 20 Lawrence Bell Dr., Ste. 100 Williamsville, NY 14221 (716) 204-9060

Parkview Health Services of NY, LLC1770 Colvin Blvd. Buffalo, NY 14223 (716) 876-2323The McGuire Group Pharmacy 2355 Union Rd., Ste. 200 Cheektowaga, NY 14227 (716) 631-2433Upstate Pharmacy Ltd 40 North America Dr., Ste. 100 West Seneca, NY 14224 (716) 675-3784Woodmark Pharmacy of New York, LLC1142 Wehrle Dr. Williamsville, NY 14221 (716) 631-3381

INDIAN HEALTH SERVICE / TRIBAL / URBAN INDIAN HEALTH PROGRAM (I/T/U) PHARMACIES

Only Native Americans and Alaska Natives have access to Indian Health Service / Tribal / Urban IndianHealth Program (I/T/U) Pharmacies through Independent Health’s pharmacy network. Those other thanNative Americans and Alaskan Natives may be able to access these pharmacies under limited circumstances(e.g., emergencies).

If you have any questions about our I/T/U Pharmacies, please contact our Medicare Member ServicesDepartment. Our contact information appears on the front and back cover pages.

For all of our I/T/U pharmacies, TTY users may call the national TTY relay service number: 711.

CATTARAUGUS COUNTYLionel R. John Health Ctr. 987 R.C. Hoag Dr., Salamanca, NY 14779(716) 945-5894

CHAUTAUQUA COUNTYCattaraugus Indian Reservation Health Ctr.36 Thomas Indian School Dr., Irving, NY 14081(716) 532-5582

SPECIALTY PHARMACIES

If you have any questions about our specialty pharmacies, please contact our Medicare Member ServicesDepartment. Our contact information appears on the front and back cover pages.

For all of our specialty pharmacies, TTY users may call the national TTY relay service number: 711.

ONCO360 640 Ellicott St.Buffalo, NY 14203Reliance Rx45 Earhart Dr., Ste. 110Amherst, NY 14221(716) 929-1000

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INDEPENDENT HEALTH’S NETWORK PHARMACIESRetail: 338Mail Order: 2Home Infusion: 4Long-Term Care: 11Indian Health Service / Tribal / Urban Indian Health Program (I/T/U) Pharmacies: 2Specialty Pharmacy: 2

We cannot cover the cost of prescriptions filled outside the United States.Beneficiaries must use networkpharmacies to access their prescription drug benefit. Benefits, formulary, pharmacy network, premiumand/or copayments/coinsurance may change on January 1 of every year.

Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO, HMO-SNP, HMO-POS, and PPO plans. Enrollment in Independent Health depends on contract renewal.

Verbal translation of written materials is available via free interpreter services. For those with special needs,accessibility to benefit information or alternate formats of written materials are available upon request.

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©2016 Independent Health Association, Inc.OA-6431-6898

IH22138 REV0116

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Important plan information.

Go Green! To get the most current provider information, visit www.independenthealth.com/findadoctor

Y0042_PH349 Accepted 09132015

For more information, please contact Independent Health’s Member Services at 1-800-665-1502 (TTY users call 1-800-432-1110), October 1 – February 14: Monday – Sunday, 8 a.m. – 8 p.m.;February 15 – September 30: Monday – Friday, 8 a.m. – 8 p.m. Or visit independenthealth.com. This pharmacy directory was updated on January 13, 2016.