Prescriptions and Pharmacies

Our health plan formularies are frequently updated to keep pace with new clinical data and evolving drug classes. Pharmacies will dispense a generic medication when available. Our goal is to maintain a clinically sound, broad formulary that will help drive generic utilization which lowers pharmacy costs for your patients. We distribute revised formularies to our members on an annual basis and will inform members and providers when changes are made. For the latest versions of our plan formularies, please visit:

US Family Health Plan

One-time medications or medications that a member needs to begin taking immediately can be filled at any participating retail pharmacy or at the Martin's Point Health Care Center Pharmacies in Portland, Maine, and Portsmouth, New Hampshire. Long-term, maintenance medications must be filled through the Martin's Point mail-order pharmacy or at the Martin's Point Health Care Center Pharmacies in Portland, Maine, and Portsmouth, New Hampshire. Members may receive up to a 90-day supply at these locations (some restrictions apply) for one copayment per prescription.

Generations Advantage

Martin's Point Generations Advantage offers a network of pharmacies with preferred cost-sharing. The Martin's Point Generations Advantage network of pharmacies with preferred cost-sharing includes Hannaford Pharmacies and Martin's Point Health Care Center Pharmacies in Portland, ME and Portsmouth, NH. The network of pharmacies with preferred cost sharing in Maine also includes Community Pharmacies in Bucksport, Dexter, Corinth, Newport, Blue Hill, and Cornish, three Paradis Shop 'n Save Pharmacies in Aroostook County, St. John Valley Pharmacy in Fort Kent, Savage's Drug DBA Unity Pharmacy, and Wilson’s Drug Store in Bath. Pharmacies with preferred cost-sharing in New Hampshire are The Medicine Store in Concord and Roberts Scarlett Pharmacy in New London. In the network of pharmacies with preferred cost-sharing, members of Generations Advantage receive medications in Tier 1, Tier 2, Tier 3, and Tier 4 of the Generations Advantage formulary (or drug list) at lower copays than at pharmacies with standard cost sharing.

Drug Prior Authorizations

US Family Health Plan is an open formulary. Certain drugs require prior authorization. This means that a member or his or her provider will need to get approval from Martin's Ppoint Health Care before the prescription is filled by calling our Provider Inquiry team at 1-888-732-7364.

Step therapy is also used to provide safe, clinically effective and cost-effective medication in drug categories that have multiple agents with comparable therapeutic efficacy. This means that these medications are only covered if the member has already tried certain medications that did not work.

For certain drugs, we may limit the amount of the drug that we will cover. The limit does not prevent providers from prescribing larger quantities if appropriate, but we will require prior authorization before covering quantities that exceed the established limit. For the latest list of drugs that require prior authorization, have quantity limits, or require step therapy, please visit the Pharmacy section of our Provider Resource Center.

Electronic Prescriptions

Martin’s Point pharmacies accept electronic prescriptions. Search for us under the following names from within your Electronic Medical Records (EMR) system:

• “Martins Pt. Mail Order Pharmacy Maine” (for US Family Health Plan members ONLY)
• “Martins Pt. Portland Clinic Maine Pharmacy”
• “Martins Pt. Portsmouth Clinic New Hampshire Pharmacy”

If you are unable to find the Martin’s Point pharmacy names as listed above, please contact your EMR system administrator and request a download of the latest list of e-prescribing pharmacies from Surescripts.®

The State of Maine allows electronic prescriptions for controlled substances. EMR software companies must take additional security and technology steps to comply with the Drug Enforcement Administration’s Interim Final Rule. Please confirm with your software vendor that they are certified by the DEA before transmitting prescriptions for controlled substances.

New York state providers, please be sure to select “Martins Pt. Mail Order Pharmacy Maine” within your EMR system rather than our Portland, ME or Portsmouth, NH clinic pharmacies when sending prescriptions for US Family Health plan members. This will prevent delays in the delivery of their medication.

Contact Information

Martin's Point Health Care
Attn: Pharmacy Department
PO Box 9746
Portland, ME 04104-5040

Martin's Point Health Care Mail-Order Pharmacy-US Family Health Plan
Phone: 1-800-707-9853
Fax: 207-828-2483

Martin's Point Clinic Pharmacy – Portland
Phone: 207-791-3756 or 1-888-408-8281
Fax: 207-828-2495

Martin's Point Clinic Pharmacy – Portsmouth
Phone: 603-436-0562  or 1-800-603-0562
Fax: 603-427-6155

Martin's Point Generations Advantage
Part D
Claims: 1-888-296-6961