Alliance Care IHSS Prescriptions

Your doctor has a list of prescription drugs that are approved by the Alliance. This list is called a formulary. A group of doctors and pharmacists reviews and updates the formulary list every year. This is to make sure that the drugs on it are safe and useful. If a drug is on the formulary list, it does not guarantee that it will be prescribed by your doctor. If your doctor thinks that you need to take a drug that is not on this list, your doctor can send MedImpact a request for prior authorization.

If you would like a copy of our formulary, please call Member Services.

We contract with a company called MedImpact for pharmacy services. Prescription drugs that need prior authorization must be authorized by MedImpact.

Drugs that need prior authorization have the letters “PA” on the formulary. The request for prior authorization lets MedImpact know why you need that drug. Prior authorization means that both your doctor and MedImpact agree that the drugs you will receive are medically necessary. MedImpact will need to approve the request before covering that drug for you. When there is more than one drug that can treat a medical condition, MedImpact may need your doctor to prescribe you the covered drug before requesting authorization to prescribe any of the others. This is known as “step therapy.” Your provider may request an exception to the step therapy process for a prescription drug.

In emergency situations, such as after a visit to the hospital, you might need your medications quickly. You may not be able to wait for a prior authorization. In these cases, your pharmacy can call MedImpact to get a 5-day emergency supply of prescription drugs for you. If there is a state of emergency issued in your local area, your pharmacy can also call MedImpact to give an emergency supply for your drugs. This means you can still get the drugs you need during an emergency without waiting for prior authorization. Ask the pharmacy to call MedImpact at 800-788-2949.

The Alliance contracts with a company called MedImpact to provide pharmacy services. If you are filling or refilling a prescription, you must get your prescribed drugs from a pharmacy that works with MedImpact. Some of the pharmacies have locations throughout California.

You can find a list of pharmacies that Alliance members can go to in the MedImpact Pharmacy Directory. Or you can call Member Services.

If you need to get a prescription filled at an out-of-area pharmacy because of an emergency or for treatment of an urgent medical condition, please ask the pharmacy to call MedImpact at 800-788-2949. They will explain to the pharmacy how they can bill MedImpact for the drug.

The MedImpact Rx Member Portal will let you access your prescription benefits to help you manage your budget and health. You can: 

• View your medications and copays. 
• Find the lowest cost for your medications. 
• Locate the pharmacies closest to you with the best cost options for your medications. 

Get started by registering on the MedImpact website.

Some prescription drugs are known as specialty drugs. These drugs may have special handling or storage requirements. You might also need extra guidance from a care team at the pharmacy for that drug. The pharmacy will let you know if any of the drugs you are prescribed are specialty drugs. They will also let you know what you need to do with them.

The Alliance has a specialty pharmacy network called MedImpact Direct Specialty. Specialty drugs are required to be filled at a pharmacy in the MedImpact Direct Specialty network. These specialty drugs have the letters “SP” on the formulary.

For any questions for MedImpact Direct Specialty, call 877-391-1103 (Monday through Friday, 5 a.m. to 5 p.m.).

If you are an Alliance Care IHSS member, you can get a 90-day supply of most prescription drugs mailed to you. Our contracted mail-order pharmacy is called Birdi.

Mail-order prescription services with standard shipping are a covered benefit for Alliance Care IHSS members.

To get your prescriptions mailed to you, please register online with Birdi. You can also register with Birdi by phone or mail.

Customer service information

Phone

Call Birdi at 855-873-8739.

Hours:

• Monday through Friday from 5 a.m. to 5 p.m.
• Saturday from 6 a.m. to 2 p.m.

When you register with Birdi, you can request refills of your current prescriptions. You can also have a new prescription sent by fax. Or your doctor can send an electronic prescription.

Once Birdi has your order, you can:

• Order refills.
• Customize your delivery options for future orders.

Ask your doctor to send your prescription to Birdi

Ask your doctor to send your prescription electronically or by fax to Birdi at 888-783-1773.

When Birdi receives a new prescription directly from your doctor, they will ask you to confirm the need for the shipment by text message, email or phone call.