All of the Piedmont Medicare Advantage plans utilize the same extensive Piedmont network our members have come to know and appreciate in the community. This includes almost all local physicians and hospitals.
Our plans will cover services from either in-network or out-of-network providers, as long as the services are covered benefits and medically necessary. However, if out-of-network providers are used, your share of costs for your services may be higher and that provider must participate in Medicare. Our Provider/Pharmacy Directory lists providers that participate in our network. Piedmont Medicare Advantage verifies the information in its provider directories through its credentialing process and quarterly outreach to providers.
Provider & Pharmacy Directory
The Provider/Pharmacy Directory provides a list of Primary Physicians, Specialists, Hospitals, Skilled Nursing Facilities, Outpatient Mental Health Providers, Other Professionals, Ancillary Facilities, Retail and Chain Pharmacies, Mail Order Pharmacies, Home Infusion Pharmacies, Long Term Care Pharmacies, and Network Pharmacies Outside the Service Area in our network. You may access our online searchable directory listed below. In order to find a provider closest to your home you may look up providers first by specialty, then by city or county. If you require assistance in finding a network provider and or pharmacy, please call 434-947-3671 or toll-free 1-877-210-1719. TTY users should call 7-1-1. To request a hard copy of the Provider/Pharmacy Directory CLICK HERE.
Piedmont Medicare Advantage verifies the information in its provider directories through its credentialing process and quarterly outreach to providers.
Piedmont Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Piedmont Medicare Advantage depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat Piedmont Medicare Advantage members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidendce of Coverage for more information, including the cost-sharing that applies to out-of-network services. The pharmacy network and/or provider network may change at any time. You will receive notice when necessary.
You can get prescription drugs shipped to your home through our network mail order delivery service. Usually a mail-order pharmacy order will arrive in no more than 10 days. If your prescription drugs have not arrived within the estimated timeframe, please call 1-866-494-9927, 24 hours a day, seven days a week. TTY users should call 7-1-1.
H1659_Web2018Updt Approved 06192018