Find a Pharmacy

Gundersen Health System

How do I find a network pharmacy away from home?

Our online pharmacy tool can locate network pharmacies throughout the United States. If you are a current member and would like help finding a network pharmacy away from home, please contact customer service. You may also find a pharmacy using the Pharmacy Benefit Online Tool, which you can access within MyChart.

What if I need to use an out-of-network pharmacy?

There are special circumstances when our plan will cover prescriptions from out- of-network providers / pharmacies:

  1. If you get sick and need medicine while you are traveling outside of the plan’s service area and there are no network pharmacies.
  2. Part D vaccines given to you in an out-of-network clinic or hospital.

If the two items above don't apply to you and you can't use a network pharmacy, you must get approval from Quartz Medicare Advantage:

  • before you buy the medicine
  • if you want the Quartz Medicare Advantage to see if they will pay for it

This process is called Prior Authorization. You need Prior Authorization to get prescriptions from out-of-network pharmacies. Your doctor/nurse can fill out the Coverage Determination form. Normal turn-around is three days unless you provide documentation that you need to know sooner.

If you already paid for the medicine and you feel we should cover it, please contact us or send the bill to us for payment review. You can find out how to do this in your Evidence of Coverage (EOC). You can see your EOC in MyChart.

To find a pharmacy in our network, please go to the Provider Directory then select the Find a Pharmacy.

This webpage was updated on September 1, 2020.