Pharmacy FAQs

Where can I get more information about the free At-Home OTC COVID-19 test?

Click here for details

Whom do I call concerning my prescriptions?

Magellan Rx Management 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?

Magellan Rx Management 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 should establish an account on the Magellan Rx portal.  Once the account has been set up, there is a “Price a Drug” function.  Members can also contact the GatorCare dedicated line at Magellan Rx Management 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 members are required to satisfy a prescription drug deductible for purchases of all  prescription drugs except Tier 0 and Tier 1 before the plan’s prescription benefits apply. The deductible amount is $125 per covered person, with a deductible cap of $500 per family. Each member will pay the deductible plus any applicable coinsurance, up to the cost of the drug. For drugs that cost less than $125, members will pay the cost of the drug, until the $125 prescription drug deductible is met. The deductible applies regardless of whether you purchase your prescription from a retail or mail order pharmacy. 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?

The UF Health Pharmacies in Gainesville, Jacksonville, and Central Florida, 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 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)
280 Fletcher Drive, 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 – Shands 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 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 Magellan Rx Management 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 Magellan 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 the  UF Health Pharmacies. Maintenance 90-day claims filled at UF Health pharmacies will receive a reduced copay (2x copay) vs claims filled at retail (2.5x Copay)

GatorCare members through UF Health Shands Gainesville are required to fill a specialty medication* through the UF Health Shands Gainesville Pharmacy unless the medication was only available through limited distribution, that is not able to be dispensed by UF Health Shands Pharmacy, or it was an emergency, for example, needed to facilitate release from the emergency department or inpatient hospital, and the UF Health Shands Pharmacy was not open over a weekend or holiday. *Specialty medications available through the pharmacy benefit usually are high cost and require special handling but can be self-administered.

Members in the Jacksonville groups are required to fill a specialty medication* at the UF Health pharmacy – Shands Jacksonville Ambulatory, unless the medication was only available through limited distribution, that is not able to be dispensed by UF Health Pharmacy – Shands Jacksonville Ambulatory, or it was an emergency, for example, needed to facilitate release from the emergency department or inpatient hospital, and the UF Health Pharmacy – Shands Jacksonville Ambulatory  was not open over a weekend or holiday. Click here for more details on specialty medication pharmacy benefits.

*Specialty medications available through the pharmacy benefit usually are high cost and require special handling but can be self-administered. 

Many specialty medications require a prior authorization before they can be dispensed. Some specialty medications are available through the medical  benefit because they require an IV infusion or must be administered by a physician in an office setting. Prior authorizations for specialty   medications on the medical plan go through Florida Blue. Prior authorizations for specialty medications on the pharmacy benefit go through Magellan.

  • Florida Blue GatorCare Customer Service – (800) 664-5295
  • Magellan Rx Management – (800) 651-8921

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

Magellan Rx Management should be contacted at (800) 651-8921 in the event a member has a question about pharmacies in the network.

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. You can use any retail chain or independent pharmacy to obtain your 90-day supply. UF Health Medical Plaza Pharmacy (888) 345-8270 or (352) 265-8270) will mail your 90-day prescription for your convenience as requested. You ca also get mail order through Walgreens Mail Order at (800)999-2655 or www.walgreens.com. Maintenance 90-day claims filled at UF Health pharmacies will receive a reduced copay (2x copay) vs claims filled at retail (2.5x 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 allergic to a generic 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, and appeal with clinical documentation must be submitted to Magellan Rx Management. Magellan Rx Management 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?

The health and prescription card are one card and 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.FloridaBlue.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. Magellan Rx Management 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 Magellan 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.