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UF Health University of Florida
GatorCare University of Florida & UF Health
on-demand urgent care
Pharmacy Overview

Pharmacy FAQs

Whom do I call concerning my prescriptions?
Prime Therapeutics is the administrator for GatorCare’s pharmacy benefits. The GatorCare dedicated toll-free number is (800) 651-8921.

What is required to have a prescription filled or refilled at the pharmacy?
A member should provide their cardholder/member number, group number, Rx BIN (016523) and PCN (P042), which is needed for processing. It is recommended to provide the pharmacy with the Rx/Prescription number as well.

The prescription plan has 6 tiers of coinsurance. How can I find out the tier for the medication being prescribed?
Prime Therapeutics has a formulary look-up tool for our GatorCare members.  The tool is user friendly and offers useful and important information. After navigating to this page, enter the name of the drug on the left hand side in the Drug Name Search field. After several seconds, possible matches will appear under the Drug Name Search field. .  Click on the drug you’re looking for.  All matches for that drug will be listed in the middle of the screen under Drug Details including the tier to which the drug is offered through the GatorCare formulary.

How can I find out the expected cost for a prescription?
Members will need to establish an account with Prime Therapeutics.  Once the account has been set up, there is a “Price a Drug” function.  Members can also contact the GatorCare dedicated line at Prime Therapeutics at (800)-651-8921. If the call is being made prior to the effective date of coverage, please advise the GatorCare customer representative that your policy is still not active, but you expect it to begin at a later date.

What is a pharmacy deductible?
GatorCare’s Brand deductible is required of members on the first paid Brand claim of the year. Upon the first Brand claim, the $125 deductible will be applied. The deductible will be added to the cost of the brand claim, regardless of Brand tier and amount of actual copay calculated. Example Tier 2 drug cost of $25 dollars, total cost for first claim would be $125 + 25 = $150. Once the Deductible has been satisfied, the future tier copay will be all that is required to be paid during that same calendar year. The examples below show the total cost due at the pharmacy once the deductible is applied to a scenario where the max copay is applied.

For more information and examples, view this document

For more information, visit gatorcare.org/pharmacy. Note: *Pharmacy deductible does not apply to Healthy Rewards HSA plans.

Are the UF Health pharmacies considered in-network?
UF Health Pharmacies, as well as the Student Health Care Pharmacy, are in-network.

UF Health Pharmacy – Shands Cancer Hospital
1515 SW Archer Road Gainesville, FL 32608
Main Phone: 733-0890 Fax: (352) 733-1291
Hours: Monday – Friday: 8:30 a.m. – 7:00 p.m.
Located next to the Adult Emergency Department and behind the Opus Café in the UF Health Shands Cancer Hospital.

UF Health Pharmacy – Shands Hospital
1600 SW Archer Road Gainesville, FL 32608
Main Phone: (352) 265-0405 Fax: 265-0133
Hours: Monday – Friday: 7:00 a.m. – 7:00 p.m. Saturday, Sunday and holidays: 9:00 a.m. – 1:00 p.m.
Located next to the UF Health Shands Hospital Atrium behind Opus Café.

UF Health Pharmacy – Medical Plaza
1549 Gale Lemerand Drive Gainesville, FL 32610
Main Phone: (352) 265-8270 Fax: 265-8276
Hours: Monday – Friday: 8:30 a.m. – 5:00 p.m.

UF Health Specialty Pharmacy
1549 Gale Lemerand Dr, Gainesville, FL 32610
Main Phone: (352) 265-8272
Hours: Monday – Friday: 8:30 a.m. – 5:00 p.m.

UF Health Pharmacy – Springhill
4197 NW 86th Terrace #1131, Gainesville, FL 32606
Main Phone: (352) 733-0090 Fax: 733-0098
Hours: Monday – Friday: 8:30 a.m. – 5:00 p.m.

UF Student Health Care Center – Infirmary Building
(GatorCare members enrolled as a student at UF)
2140 Stadium Road, Gainesville FL 32611
Main Phone:  (352) 392-1161 or (866) 941-1760
Hours: (subject to change during holidays/breaks)
Fall/Spring: M-F 8:00 a.m. – 5:00 p.m.; Sun 12:00 p.m. – 4:00 p.m.; Summer: M-F 8:00 a.m. – 4:30 p.m.

UF Health Pharmacy – Jacksonville Ambulatory
655 W. 8th Street, Jacksonville, FL 32209
Located in the Ambulatory Care Center (ACC) building on the first floor.
Main Phone: (904) 244-4020
Hours: Monday – Friday: 8:30 a.m. – 5:00 p.m.

UF Health Pharmacy – World Equestrian Center
2051 NW 80th Ct, Suite 200
Ocala, FL 34482
Main Phone: (352) 421-7700
Hours: Monday – Friday: 8:00 a.m. – 6:00 p.m., Saturday – Sunday: 10:00 a.m.-5:00 p.m.

UF Health Central Florida Pharmacy – Leesburg
600 E. Dixie Avenue
Leesburg, FL 34748
Main Phone: (352) 323-5384
Hours: Monday – Friday: 7:30 a.m. – 4:00 p.m. (closed 12:30 – 1:00 for lunch)

Are there other pharmacies that are considered in-network?
The Prime Therapeutics network includes more than 60,000 retail pharmacies. All major chains are included ( Walgreens, CVS, Publix, Winn Dixie, Target, Kroger, etc.) as well as some local independent pharmacies.  Members can verify if a pharmacy is in-network on the Prime Therapeutics website or by calling customer service at (800)-651-8921.

Am I required to use a UF Health Pharmacy?
All members are encouraged to use UF Health Pharmacies. Maintenance 90-day claims filled at UF Health pharmacies will receive a reduced copay (2x copay) vs claims filled at retail (3x Copay).

Specialty Medication Pharmacy Requirements
GatorCare’s pharmacy benefit uses UF Health Pharmacy as the specialty pharmacy provider.

UF Health pharmacies provide specialty medications to support safe handling, clinical oversight, and coordinated care for GatorCare members.

*Specialty medications are typically high-cost medications that require special handling or monitoring and are generally self-administered.

The following UF Health Specialty Pharmacies provide delivery and shipping services:

UF Health Medical Plaza / Specialty Pharmacy – Gainesville
1549 Gale Lemerand Dr, Gainesville, FL 32610
📞 Phone: 352-265-8272
📠 Fax: 352-265-8276
🕒 Hours: Monday–Friday, 8:30 a.m.–5:00 p.m.
📞 Refill call-in line: Available 24/7
🌐 Website: https://ufhealth.org/locations/uf-health-specialty-pharmacy-2

UF Health Ambulatory / Specialty Pharmacy – Jacksonville
655 West 8th Street, Jacksonville, FL 32209
📞 Phone: 904-244-4020
📠 Fax: 904-244-3752
🕒 Hours: Monday–Friday, 8:30 a.m.–5:00 p.m.
📞 Refill call-in line: Available 24/7
🌐 Website: https://ufhealthjax.org/pharmacy

A specialty medication must be filled through a UF Health Pharmacy unless one of the following applies:

  • The medication is available only through limited distribution and cannot be dispensed by a UF Health pharmacy
  • The medication is needed in an emergency situation, such as to facilitate discharge from the emergency department or an inpatient stay, and the UF Health pharmacy is not open (for example, during a weekend or holiday)
  • The member lives outside the state of Florida

Members Living Outside the State of Florida
GatorCare members who live outside the state of Florida may obtain their specialty medications through Prime Therapeutics Home Delivery (Prime Mail Order).

Prime Therapeutics – Home Delivery (Mail Order)
Phone: (800) 424-7716
Mailing Address:
PO Box 620968
Orlando, FL 32862

Prime Therapeutics Home Delivery can assist with medication access, delivery coordination, and questions related to specialty medications for members residing outside Florida.

Prior Authorization for Specialty Medications
Many specialty medications require prior authorization before they can be dispensed.

Specialty medications covered under the pharmacy benefit require prior authorization through Prime Therapeutics.

Specialty medications covered under the medical benefit—such as those requiring IV infusion or administration by a provider in a clinical setting—require prior authorization through Florida Blue.

  • Florida Blue GatorCare Customer Service – 1-855-393-1085
  • Prime Therapeutics – (800) 651-8921

Routine requests for prior authorization have up to a 15-day turnaround time.  Urgent requests are usually processed within 72 hours.

What is the Value Max Copay Assistance Program?
The Value Max program helps Prime Therapeutics identify copay assistance available for costly specialty medications and select diabetic medications.

Value Max will connect you to programs where medication manufacturers help pay for certain high-cost medications. These programs are called copay assistance programs and require a manufacturer copay card.

GatorCare’s pharmacy benefit plan uses UF Health Pharmacies as their exclusive specialty pharmacy provider, so to take advantage of the Value Max program members must fill specialty and diabetic Value Max medications via a UF Health Pharmacy.

Please note: You may not be eligible to use a manufacturer copay assistance card if you have a secondary government insurance plan, even if that plan is not used to fill the medication. Examples of some government insurance plans include but are not limited to Medicaid, Medicare, Medicare D, and TriCare.

Find more information and a list of FAQs here

Am I required to order a 90-day supply for my maintenance medication?
Yes, members are required to fill their Tier 0-2 maintenance medications at a 90-day supply. Maintenance 90-day claims filled at UF Health pharmacies will receive a reduced copay (2x copay) vs claims filled at retail (3x Copay).

If my Physician prescribes a medication that has a generic equivalent, will the plan allow me to have the prescription filled as written and not require me to accept the generic?
 The pharmacy benefits permit a member to have the prescription filled as written, but the member is required to pay the brand copay plus the difference in cost between the brand and generic if you choose a brand product when a generic equivalent is available.

If I am allergic to a generic drug or if my physician has determined that I cannot take a generic drug, what process must I follow to receive an exception?
To request an exception, an appeal with clinical documentation must be submitted to Prime Therapeutics.
Prime Therapeutics can be reached at (800) 651-8921.

I’m a new member and need to have a prescription filled and I do not have my new ID card. What should I do?
Member ID cards are one card for both medical and pharmacy benefits, therefore members will not have a separate card for prescriptions. If you need a prescription filled and have not received your GatorCare ID card, please contact Florida Blue. There are two on-site representatives to assist you, or you can call the toll-free number.                                             

You can also print a temporary card directly from Florida Blue by logging on to www.FLBlueGroupBenefits.com and signing in. Click on my account, and choose the ID Card Services.

I am a new member. What is required to have a prescription filled or refilled at the pharmacy I’ve been using for years?
A member should provide their cardholder/member number, group number, Rx BIN (016523) and PCN (P042), which is needed for processing. It is recommended to provide the pharmacy with the Rx/Prescription number as well.

What is the process to have a prescription filled that requires a prior authorization?
If a Prior Authorization is required for your medication, provide your prescriber with the prior authorization form located here or have them call 1-800-651-8921 to request your prior authorization as soon as possible. Prime Therapeutics will notify you and your prescriber if the prior authorization is approved or denied. If approved, your medication will be covered at the appropriate co-payment or co-insurance under your plan. If denied, you can either purchase the drug for the full price or discuss alternatives with your doctor or appeal the decision through Prime Therapeutics at the number listed above.

How often can I refill my medication
Non-Opioid Medications:

  • Retail: 7 days remaining
  •  Extended Supply at Retail: 11 days remaining
  •  Mail Order: 11 days remaining

Non-Opioid Maintenance Medications:

  • Retail: 7 days remaining
  • Extended Supply at Retail: 11 days remaining
  • Mail Order: 11 days remaining

Opioid Medications:        

  • Opioid Naïve (First-Time) members must first fill for 7 days or less; After that, All Short-Acting Opioids (SAOs) cannot be filled more than once (1) in 29 days.
  • Example: If you last filled your prescription on May 11th the next available day to fill the prescription will be on June 9th.

Schedule Two (2) Medications:

  • Schedule Two (2) medications are limited a maximum day supply of up to 34 days. Please contact your pharmacy in determining if your medications fits this classification.
  • For more information on drug class scheduling from the Drug Enforcement Agency (DEA) visit: Drug Scheduling (dea.gov)

For full details about your benefits please read all available documents located at https://gatorcare.org/plans/. Once on that page, select your specific employer plan.

In the event that any ambiguity arises between these highlights and the Certificates of Insurance or the Plan Documents, the terms of the Certificates and Plan Documents will prevail.