CVS Caremark will manage pharmacy benefits for select CU Health Plans for the coming plan year, beginning July 1. It’s the biggest change this Open Enrollment, meaning University of Colorado faculty and staff may have questions about what it means for them.
This change is poised to improve CU Health Plan members’ pharmacy benefits coverage by adding efficiency and convenience, keeping drug prices at current levels and easing administration of member benefits.
On July 1, the CU Health Plan will use CVS Caremark to manage Anthem plan members’ pharmacy benefits and discontinue pharmacy benefit services with Anthem’s IngenioRx.
Anthem-administered CU Health Plans include Exclusive, Extended, High Deductible and Medicare.
UCHealth Pharmacy Services will continue to fill mail-order prescriptions for Anthem plan members. Medicare members can use either UCHealth Pharmacy Services or CVS Caremark mail order services.
What’s staying the same?
The switch to CVS Caremark will not affect member copays or deductibles.
Will I need to change my pharmacy?
No. The CVS network encompasses a total of 68,000 locations, including CVS and Target pharmacies as well as the pharmacies you’ve used during the current plan year.
The locator tool online at Caremark.com or in the CVS Caremark mobile app will help you find nearby pharmacies within your plan. The locator tool allows members to limit search results based on distance, store name, language spoken and services offered.
How will the transition work?
CU Health Plan members enrolled in an Anthem plan will be kept updated on how their pharmacy benefits coverage may be affected by 2020-21 plan year developments throughout the transition.
The current formulary will have some slight adjustments for covered drugs. The CVS Caremark team will contact your doctor to collect information required by your benefit plan to determine if the prescription is covered. You and your doctor will be notified of the status of your prior authorizations (PA) as soon as possible – usually within a few days.
CVS Caremark will complete all prior authorizations (PA) and appeals as of July 1. Any active authorizations will remain on file (some exclusions apply), and they will extend specialty authorizations for 180 days.
How will I know if my medication is still covered?
If you or your dependents have a current medication not on the CVS Caremark formulary, you will receive a letter(s) by June 2020 to help you transition to your new pharmacy benefits plan.
In addition to a welcome kit, you will be sent a specific mailing outlining the change and alternatives to discuss with your prescriber.
Until you receive your welcome kit, visit info.caremark.com/acsdruglist to check the formulary for prescription drug coverage. Make selections based on your drug to search this site. This site also includes specialty prescription coverage information.
Will I get a new Medical ID card?
If you’re enrolled in the Exclusive, Extended, High Deductible or Medicare CU Health Plans, you’ll receive separate identification cards for your medical and pharmacy benefits – one from Anthem and one from CVS Caremark.
The CVS Caremark card and welcome kit should arrive no later than June 30, 2020.
How do I contact CVS Caremark with questions about my pharmacy benefits?
Call the CVS Caremark Customer Care phone line for CU Health Plan at 1-888-964-0121. The line is open 24 hours a day, seven days a week.
More Open Enrollment details
Open Enrollment is your annual opportunity to keep, waive or enroll in the University of Colorado’s medical, dental, vision, flexible spending accounts, life and disability insurance. Use this period to examine your current health and wellness options, then adjust your benefits accordingly by 5 p.m. May 8.
Changes to health benefits for the 2020-21 plan year were made with member satisfaction, process improvement and efficiency in mind. If you would like to keep the same benefit plans, no action is required and you will be automatically re-enrolled. There's one exception: If you have a Health Care Flexible Spending Account and a Dependent Care Flexible Spending Account, you must re-enroll.
For more information, check out what’s changing for the 2020-21 plan year.
Questions about your benefits? CU’s benefits counselors are here to help
As always, CU Employee Services benefits counselors are available to answer questions and to direct you to resources to inform your health care decisions. Benefits office hours are 8 a.m.-5 p.m. Monday through Friday. Please don’t hesitate to reach out.