PharmaCare and Me

Enroll online with our Easy Enrollment Form

For personal attention call us today:
1-800-238-7828

Is PharmaCare Right For Me?
Blue Rule

It's a fact that many individuals who live with challenging health conditions can benefit from specialized pharmacy care. Specialized pharmacy care can help to improve outcomes and reduce the stress often associated with complex medication regimens.

This questionnaire will help you determine if one of PharmaCare's specialized pharmacy care programs are right for you. Simply complete the form below and click "submit".

Are you being treated for one or more of the following conditions?
Cancer
Hepatitis
HIV/AIDS
Infertility
Pre- or post-transplant
End stage renal disease
Yes No
Are you currently on a treatment regimen that requires self-injection?
Yes No
Do you regularly take three or more medications a month, including at least two maintenance drugs (drugs you take on an ongoing basis)?
Yes No
Do you expect to be taking additional medications for your condition in the future?
Yes No
Is your medication sometimes difficult to find at local drugstores?
Yes No
Is it difficult for you to afford your medication costs or do you have difficulty managing the paper-work involved with your prescription coverage?
Yes No