Pharmacy Services

Welcome, members!

As the pharmacy benefits manager (“PBM”), Ayin Administrative Health Solutions brought to you by Providence Plan Partners administers your prescription drug benefits that have been designed by your employer. We’re pleased to partner together to bring you comprehensive prescription drug benefits. Use the resources below to get to know and make the most of your pharmacy benefits.

Prescription drug formularies

Formularies are designed to promote safe, effective and affordable drug therapy.

2021 Ayin Formulary

2022 Ayin Formulary

You can search the formulary alphabetically by entering a portion of the drug name or by therapeutic class. You can see additional information about each medication, including special considerations about the prescription, when applicable.

Prescription drug plan information

Log into your secure member website to view your plan materials.

Refer to the provider directory to find in-network pharmacies.

Types of in-network pharmacies

A pharmacy that can supply up to a one-month supply of prescription medications.

A preferred retail pharmacy can supply up to a 90-day supply of prescription medications.

A mail-order pharmacy can provide up to a 90-day supply of maintenance medications and delivers prescriptions directly to your home.

All covered members and their qualified dependents have access to these mail order pharmacies. Your network provisions may require the use of just one of these mail order pharmacies for coverage. Please call the Providence Health Plan Pharmacy Department at 877-216-3644 if you have questions.

Postal Prescription Services

503-797-2100 or 800-552-6694
Monday to Friday, 6 a.m. to 6 p.m. PT; Saturday, 9 a.m. to 2 p.m. PT
Mailing address: P.O. Box 2718, Portland, OR 97208
Automated refill line available 24/7, 365 days a year: 800-552-6694

Costco Home Delivery

800-607-6861
Fax: 800-633-0334
Monday to Friday, 5 a.m. to 7 p.m. PT; Saturday, 9:30 a.m. to 2 p.m. PT
Pharmacy is available 24/7 to refill prescriptions, order new prescriptions and check prescription status.
Mailing address: 802 134th St. SW, Ste 140, Everett, WA 98204-7314
Contact Costco Home Delivery Pharmacy by email.

A pharmacy that provides specialty medications – medications that require special delivery, handling, administration and monitoring by a pharmacist. They are listed on the formulary with the status of “specialty.” Specialty drugs are available through Credena Health. Some specialty drugs are only available in select pharmacies. If Credena Health is not able to provide a specialty medication, members should contact the Pharmacy Department at 503-574-7400 or 877-216-3644.

Prior authorization

A limited number of prescriptions need to be prior authorized before the drug is dispensed. Many factors – including serious risks, Food and Drug Administration approved indications and cost-effectiveness – are considered before making the decision to require prior authorization of a prescription medication. The prior-authorization process is initiated by your provider. Talk with your doctor or other health care provider to initiate prior authorization or consider changing your prescription to an effective formulary alternative.

Forms

Prescription Drug
Reimbursement Request Form

Prescription Drug
Prior Authorization Request Form

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