Pharmacy and Drug Benefits

pharmacyWe understand that pharmacy access and getting your prescription drugs are important for your health. Alameda Alliance for Health provides the information below to help you locate a pharmacy and better understand your drug benefits. 

Find a Pharmacy

There are close to 200 pharmacies in the Alliance pharmacy network in Alameda County. To find a pharmacy near where you live or work, please use the pharmacy directory below. You can also call the Alliance Member Services department at 510-747-4567, 1-877-932-2738, or CRS/TTY 711 or 1-800-735-2929, 8:00 am to 5:00 pm, Monday through Friday.

Pharmacy Locator

Alliance Drug Formulary

The Alliance maintains a Drug Formulary, which is an approved drug list. It includes common drugs that are prescribed by the doctors in our network. These drugs have been chosen for their quality, safety and cost.

A group of doctors and pharmacists regularly review our drug formulary to ensure it includes newly available drugs. You can find out if your drug is covered by looking in the Alliance Drug Formulary, which is available as a detailed listing (comprehensive) or as a summary (abridged).

Important Information

There are some procedures and limits, explained below, that may apply to the drugs in our formulary.

General Substitution
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The Alliance has a mandatory generic program. This program promotes the use of generic options over brand when medically appropriate. When your doctor writes you a prescription for a brand name drug and not a generic due to medical need, your doctor must submit a Prior Authorization Form to the Alliance. The Alliance reviews these requests and asks for more information if needed. Otherwise we will inform the doctor of our decision within five (5) business days of non-urgent requests and 72 hours (three [3] business days) of urgent requests.

Step Therapy
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In some cases, the Alliance requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B. Your doctor can request an exception by submitting a Prior Authorization Form to us. The Alliance reviews these requests and asks for more information if needed. Otherwise we will inform the doctor of the decision within five (5) business days of non-urgent requests and 72 hours (three [3] business days) of urgent requests .

Quantity Limits
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For certain drugs, the Alliance has a limit on the number of pills we will cover. In general, a 30-day supply is covered. However, if you require a drug that exceeds the limit, your doctor can submit a Prior Authorization Form to us. The Alliance reviews these requests and asks for more information if needed. Otherwise we will inform the doctor of the decision within five (5) business days of non-urgent requests and 72 hours (three [3] business days) of urgent requests.

Prior Authorization Process
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For drugs that are not in our Drug Formulary or that exceed the plan quantity limits, your doctor can submit a Prior Authorization Form to us. The Alliance reviews these requests and asks for more information if needed. Otherwise we will inform the doctor of the decision within five (5) business days of non-urgent requests and 72 hours (three [3] business days) of urgent requests.