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Pharmacy Services
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Pharmacy Services

If you are in need of immediate medical attention, contact your physician, poison control center or emergency medical professional. Due to the high number of requests we receive, the replies can take up to two business days.

The information appearing in this resource is intended to be a general guide to the costs and choices available under your prescription drug plan. The actual coverage may vary. Please refer to your AultCare membership card and specific plan benefit information for more detail. If you need to speak with a representative, please call AultCare Customer Service at 330-363-6360 or 1-800-344-8858. 

To locate a pharmacy, please click Account Login to use your personalized Pharmacy Directory associated with your plan.

 

How to Find a Pharmacy - PDF

 

Formularies

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Formularies

The formulary listings are intended for the use and application of plans subject to the AultCare formulary.

At AultCare, we are committed to providing you with affordable prescription coverage. Each formulary is a comprehensive guide that was developed based on sound clinical evidence and reflects current treatment guidelines and community practice standards.

These formularies have been approved by our Pharmacy & Therapeutics Committee, which reviews the medications based on safety and efficacy. This committee is made up of distinguished healthcare professionals, including pharmacists and physicians from various medical specialties. AultCare works to keep your prescription coverage affordable while making sure your physician can continue to provide you with the best care.

If you have additional questions or are not sure which formulary your plan has, please contact AultCare at 1-800-344-8858.

If your plan is tied to a managed formulary, only specific drugs in each therapeutic class are covered. Medications not listed on our formulary are not covered under the plans.

Formularies

Mail Orders Rx

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Mail Orders Rx 1

Optum Mail-Order Pharmacy - 1-866-868-2372


Specialty Mail-Order Pharmacy

Contact Information:
33381 Walker Road, Suite A
Avon Lake, OH 44012 ‍

Phone: 1-844-4-GENTRY (443-6879)
Fax: 1-844-FAX2GHS(329-2447)

Website: www.gentryhealthservices.com

Optum Specialty Pharmacy-

Contact Information:
OptumRx
PO Box 2975
Mission, KS 66201-1375

Phone: 1-855-427-4682

Website: specialty.optumrx.com

Ask the Pharmacist

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Ask a Pharmacist and Drug Recalls

Ask the Pharmacist

Can generic drugs really save me money?
Yes, generic drugs can save you up to 80% on the cost of a prescription when compared with the brand-name drug. Most often, the savings range from 30% to 50%.

Drug Recalls

Please click on the drug name below to download a PDF regarding the recall (as of 01/06/25):

Non-Formulary Coverage Determination

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Non Formulary Coverage Determination

Non-Formulary Coverage Determination

Managed Formulary Exception Enrollment Form

The AultCare managed formularies are designed to provide value. Only specific drugs in each therapeutic class are covered. The formulary designs provide adequate options in each therapeutic category and include most generics and selected brands. Unless a coverage determination is approved, only medications listed on the formulary are covered under your plan.

How to ask for a coverage decision for a non-formulary (not covered) medication.
You may ask our plan to make a coverage decision about the drug(s) you need that are not covered on your managed formulary. If your health requires a quick response, you must ask us to make an "urgent or expedited" decision if you are asking us to pay you back for a drug you already bought.

What to do:
You or your doctor (or another prescriber) can request a coverage determination by calling, emailing, writing or faxing our plan at the numbers below.

Telephone: 330-363-6360 or
toll free 1-800-344-8858

Email: AultCarePharmacy@aultcare.com

Fax: 330-363-3284

Mail: Attn: AultCare Pharmacy Department, 2600 Sixth Street SW, Canton, Ohio 44710

When we give you our decision, we will use the "standard" deadlines unless we have agreed to use the urgent or expedited deadlines. A standard decision means we will give you an answer within 72 hours. An urgent or expedited decision means we will give you an answer within 24 hours.

To get an expedited decision, you must meet the following requirement:

  • If using the standard deadlines could cause serious harm to your health or hurt your ability to function (e.g. when an enrollee is suffering from a serious health condition and currently undergoing a current course of treatment using a non-formulary drug).
  • If your doctor or other prescriber tells us that your health requires an "expedited decision," we will automatically agree to give you an expedited decision.
  • If you ask for an expedited decision on your own (without your doctor's or other prescriber's support), our plan will decide whether your health requires that we give you an expedited decision.
  • If we decide that your medical condition does not meet the requirements for an expedited decision, we will verbally communicate with you.

Our plan can approve or deny your request:

If we approve your request we will provide the coverage we have agreed to within the appropriate time frame. If we deny your request, we will send you a written notice that explains why we denied it. If your request is denied, you have the right to request an appeal. Requesting an appeal means asking us to reconsider – and possibly change – the decision we made.