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Legacy Expanded

 Employee Health Plan Information

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Pharmacy benefits

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 Caremark.com 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.)

Weight loss drugs

  • Weight loss drugs are not a covered benefit under the Legacy plans. Some manufacturers may provide a drug card to cover these prescriptions at a copay that does not run through your health plan. When these drug cards expire, the cost will be your responsibility.

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.

Things to remember

  • 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 similar drugs on your drug list are not effective for you, and the prescription has received prior authorization.

Legacy Expanded Network

Your plan covers eligible services both in and out of network, as well as nationwide; however, you will pay more for most out-of-network care. 

  • Please note: OHSU and affiliates are out-of-network on this plan.
  • Out-of-network emergency and urgent care services for nonroutine care are covered at the in-network level.
  • You can find a local in-network provider by calling the number on the back of your ID card or click the button below to access the Legacy Expanded provider directory.

Find a Legacy Expanded provider

  • Beyond Idaho, Montana, Oregon, and Washington, you can access in-network care nationwide through our collaboration with Aetna Signature Administrators®.

Find an Aetna provider

Mobile apps

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

PacificSource app example

 

myPacificSource app:

  • Access your ID card, anytime.
  • Find a provider, hospital, or urgent care center.
  • Check your deductible and out-of-pocket totals.
     
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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.
 

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Other prescription drug information

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
    503-413-4225
    Fax 503-413-4515
  • The Apothecary–Legacy Good Samaritan
    1040 NW 22nd Ave Suite 100
    Portland OR 97210
    503-413-8122
    Fax 503-413-8453
  • Legacy Meridian Park Community Pharmacy
    19300 SW 65th Ave
    Tualatin OR 97062
    503-692-2662
    Fax 503-692-7437
  • Woodburn Pharmacy at Woodburn Health Center
    1475 Mt Hood Ave
    Woodburn OR 97071
    971-983-5290
    Fax 971-216-0090
  • Legacy Apothecary-Legacy Salmon Creek
    2121 NE 139TH St Suite 310
    Vancouver WA 98686
    360-487-3700
    Fax 360-487-3709

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.

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)

LegacyEHP@PacificSource.com 

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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

888-581-3648
EyeMed

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

Prior authorizations

Learn whether a procedure requires prior authorization. Visit our Provider Authorization Grid and select "Commercial" from the left column to get started.

Documents and forms

Contacts

PacificSource Customer Service
(for 
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)
LegacyEHP@PacificSource.com

Dental 

Moda 
Portland: 
503-243-3886
Outside Portland: 888-281-0405


Vision 

EyeMed 
888-581-3648

COBRA

PacificSource Administrators
877-355-2760
Mail Payments to:
PacificSource Administrators
PO Box 2440
Omaha, NE 68103-2440