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Legacy Employee
Health Plan Information

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New pharmacy benefits

Effective January 1, 2022, your pharmacy benefits will be administered through PacificSource and CVS Caremark. You will need to present your new ID card to your pharmacy when you pick up prescriptions starting January 1, 2022. There will be minor changes to your benefits, so please check your Legacy Employee Benefits Guide, InTouch, and the Summary of Material Modification. Your drug list is called “Preferred PDL.” You may access your prescription information online through InTouch or at

Advantages of getting prescriptions filled at Legacy Apothecaries

  • Get a 90-day supply of medications for the cost of a 60-day supply.
  • Most specialty pharmacy medications will continue to be available through Legacy Apothecaries.

Using Caremark pharmacies

  • Most major pharmacy chains, including CVS, Walgreens, and Rite Aid, as well as many independent pharmacies, are in network. Check to ensure your pharmacy is in network.
  • Get up to a 90-day supply of maintenance medications at one time through retail pharmacies. (Prescriptions will need to reflect a 90-day supply.)

Diabetic supplies

  • Diabetic supplies, such as meters, continuous glucose monitors, lancets, needles, and syringes, will be covered now under your pharmacy benefit in addition to your medical benefits.
  • Some diabetic medications may no longer be on your drug list. Be sure to check the drug list to make sure your medication is still included. If your medication is no longer listed, please contact your doctor to discuss your options.

What has changed?

  • Over-the-counter medications are no longer covered unless they are prescription strength and you have a prescription from your provider.
  • A compound medication will only be covered if drugs on your drug list are not effective and the prescription has received prior authorization.
  • There will be a lifetime maximum applied to infertility medications. (You must meet a specified waiting period to be eligible for infertility benefits.)



Legacy+ Network

Your medical plans cover eligible services and supplies from Legacy+ network facilities for enrolled employees and dependents. All labs and advanced imaging services must be provided at a Legacy Health facility. Please give this notice to your providers when seeking care: Legacy Employee Health Plan: Crucial Information for Providers

Out-of-network coverage is not covered except for:

  • Medically necessary covered services not available through the Legacy+ Network*
  • Urgent and Emergency Care
  • Diabetic supplies (also available through CVS Caremark) 

*Prior authorization from PacificSource is required before services are rendered.

Please note, there is not a benefit for out-of-network alternative care. You will need to go to in-network chiropractors, acupuncturists, massage therapists, and naturopaths in order to have these services covered under the plan.

Find a Legacy+ Provider



Note about lab work
and imaging

If your provider is not a Legacy Medical Group provider and you need lab work, ask for a written order and take to a Legacy Laboratory to have your labs drawn and processed. You must also go to a Legacy facility for services such as mammograms, and all advanced imaging such as CT scans, MRIs, etc. Your provider may not be aware that out-of-network providers and facilities are NOT COVERED under your employee health plan.

Please give the notice, “Legacy Employee Health Plan: Crucial Information for Providers,” to your providers. This notice informs them about sending your labs, advanced imaging referrals, and so on to only in-network Legacy providers and facilities

Manage your benefits and health, 24/7

Sign up for InTouch for secure, online access to your plan's benefits. Plus tools and resources to support your well-being.

Sign up for InTouch

Mobile apps

The free myPacificSource and myPacificSource Admin (PSA) mobile apps let you manage your benefits, wherever you are.

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myPacificSource app:

  • Access your ID card, anytime.
  • Call our 24-Hour NurseLine.
  • Find a provider, hospital, or urgent care center.
  • Check your deductible and out-of-pocket totals.
Download the myPacificSource app on Android
Download the myPacificSource app from Apple


psa phone screen and app







myPacificSource Admin (PSA) app:

  • Manage your FSA or other reimbursement accounts

Download the app today, and log in with your PSA account username and password.

Download the myPacificSource app on Android
Download the myPacificSource app from Apple


Find a drug

Starting January 1, 2022, your pharmacy is with PacificSource and CVS, not MedImpact.

Use the search field to see if a prescription drug is covered by your plan: Simply select the year and “Preferred (PDL).”

Find a drug

Other prescription drug information

Enhanced Drug List offers top value

The Enhanced Drug List for Legacy employees is a benefit that allows certain drugs to be covered with a $5 copay. Most diabetic supplies are covered at 100%. This list is a separate benefit from preventive drugs covered under the Affordable Care Act.

See the Legacy Enhanced Drug List

Utilization Management

For certain prescription drugs, we have additional coverage requirements or limits. Learn more about utilization management, including prior authorization, quantity limits, and step therapy.

Affordable Care Act Standard Preventive No-cost Drug List (CVS Caremark)

The ACA Standard Preventive No-cost Drug List contains medications required by the government to be available at no cost to members of a health insurance plan. The list is maintained by CVS Caremark.  

Find a pharmacy

Get your prescriptions at the best price through a Legacy pharmacy. Specialty drugs and home delivery by mail are also available.

  • The Apothecary–Legacy Mount Hood
    24800 SE Stark
    Gresham OR 97030
    503-674-1597, fax 503-674-1650
  • The Apothecary–Legacy Emanuel
    501 N Graham
    Portland OR 97227
    Fax 403-413-4515
  • The Apothecary–Legacy Good Samaritan
    1040 NW 22nd Ave Suite 100
    Portland OR 97210
    Fax 503-413-8453
  • Legacy Meridian Park Community Pharmacy
    19300 SW 65th Ave
    Tualatin OR 97062
    Fax 503-692-7437
  • Woodburn Pharmacy at Woodburn Health Center
    1475 Mt Hood Ave
    Woodburn OR 97071
    Fax 971-216-0090
  • Legacy Apothecary-Legacy Salmon Creek
    2121 NE 139TH St, Suite 310
    Vancouver WA 98686
    Fax 360-487-3709

Find another CVS pharmacy

Your pharmacy, dental, and vision benefits

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Pharmacy Coverage

Need prescription drugs? Your pharmacy benefits are provided by PacificSource and CVS Caremark.

Starting January 1, 2022, your pharmacy is with PacificSource and CVS Caremark, not MedImpact.

Prescription drug information

971-222-1050 (local Portland area, M-F, 7:00 a.m. to 5:00 p.m.)

844-520-5347 (toll-free) 

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Dental Plan

Your dental benefits are not through PacificSource, but are instead provided by Moda Health.

Portland: 503-243-3886
Elsewhere: 888-281-0405
Moda Health

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Vision Plan

Vision coverage is offered through EyeMed


More benefits



Quitting tobacco
for good

The Quit For Life tobacco cessation program is brought to you by the American Cancer Society® and Optum®

  • There is no cost to participate
  • PacificSource covers unlimited quit attempts
  • You’ll receive ongoing support throughout the process

Enroll in Quit for Life




Support your health goals with:

  • Personalized health resources and action plans
  • Activities, wellness challenges, and expert health coaching
  • Communities of health experts
  • Helpful tips and articles on a variety of health and wellness topics

Access CaféWell

Flexible Spending Account

Manage your FSA account from the convenience of your home, office or phone.

  • View account information
  • Submit a claim
  • Update your personal information
  • Change your direct deposit preferences

Download the MyPacificSource Admin app for iOS or Android to access your account on your mobile device.

Log into FSA account

Legacy Employee health plan news


FSA can now be used for over-the-counter products

The CARES Act permanently reinstated over-the-counter products as eligible expenses for flexible spending account (FSA) funds without a prescription. This reverses laws put in place by the Affordable Care Act nearly 10 years ago, which stated that those expenses were only eligible for reimbursement with a prescription.

Includes menstrual care products
As part of the legislation, menstrual care products were added as eligible expenses. That means employees can now use their HSA, FSA, and HRA funds to purchase items such as tampons, pads, and menstrual sponges. This change, and the general over-the-counter change above take place retroactive to January 1, 2020

Additional changes to FSA accounts

For the 2021 and 2022 plan years, the full amount in your FSA Health Care and Dependent Care account can be rolled over into the next year.  This is a change from the previous limit of $550 that could roll over from your Health Care account and $0 that could roll over from your Dependent Care account to the next plan year.  Rollover funds will be available after the runout claims for the prior year are processed, by the end of April.
Available funds in your dependent care account may now be used for work-related care or care while looking for another job, after being laid off or terminated from employment with Legacy.

Use in-network Legacy providers for labs and imaging

Please give the notice, “Legacy Employee Health Plan: Crucial Information for Providers,” to your providers. This notice informs them about sending your labs, advanced imaging referrals, and so on to only in-network Legacy providers and facilities. Your provider may not be aware that out-of-network providers and facilities are not covered under your employee health plan.

Documents and forms


PacificSource Customer Service
medical, pharmacy, and FSA benefits)

971-222-1050 (local Portland area,
M-F, 7:00 a.m. to 5:00 p.m.)

844-520-5347 (toll-free)


Outside Portland: 888-281-0405




PacificSource Administrators
Mail Payments to:
PacificSource Administrators
PO Box 2440
Omaha, NE 68103-2440