Mail Service Transition To Medco For 2008

Effective January 1, 2008, Medco will administer the Service Benefit Plan Mail Service Prescription Drug Program. Caremark will continue as the Retail Pharmacy provider. You can look at a preview of the Medco web site under Open Season. On December 1, 2007, you can access the Medco web site under Pharmacy Programs.

Why the change from Caremark to Medco?

The Blue Cross and Blue Shield Association (BCBSA) contracts with Pharmacy Benefit Management companies (PBMs) to provide pharmacy services for Service Benefit Plan members: the Mail Service Prescription Drug Program and Retail Pharmacy Program. Periodically, BCBSA surveys the marketplace to determine if the current retail and mail service contracts offer the best value in terms of customer service, drug discounts, network configuration, and dispensing operations. After careful review, BCBSA determined that using Caremark for Retail Pharmacy Services and Medco for Mail Pharmacy Services offered the best value to our members.

What do you mean by best overall value?

In the area of Pharmacy Benefits, best overall value is defined by customer service, network configuration, drug discounts, and dispensing operations. Obtaining best overall value helps to hold down increases in member premiums and prescription copayments.

How will this change benefit me?

We believe the change in the Mail Service Prescription Drug Program provider enables us to continue to provide our members with a comprehensive health benefits package that includes coverage for prescription drugs at an affordable cost.

Who made the decision to switch vendors?

BCBSA is responsible for the selection and performance of pharmacy vendors. After a competitive procurement, BCBSA determined that a combination of Caremark for Retail Pharmacy Services and Medco for Mail Pharmacy Services offered the most compelling value to the Service Benefit Plan and its members.

When is the change effective?

Effective January 1, 2008, Medco will be the new Mail Service Prescription Drug Program provider replacing Caremark. Caremark will continue to provide Retail Pharmacy Services. For the remainder of 2007, Caremark will continue to provide both Mail Service and Retail Pharmacy Services.

Can I still use my local drugstore for my prescription in 2008?

Members can continue to use the local drug store of their choice in 2008. Caremark Inc. will continue to provide Retail services for the Service Benefit Plan.

Will my mail service pharmacy copayments change?

No. Your copayments are still $10 for generic drugs and $35 for brand-name drugs.

Will there be any changes to the prior approval program?

No. For a list of drugs requiring prior approval, please visit Pharmacy Programs.

Where do I send specific questions about my mail service benefit?

You can send all correspondence, including inquiries, personal representative authorization forms, etc., to Medco Health Solutions, L.L.C., P.O. Box 30496, Tampa, FL 33630-3496.

How will Medco handle prescriptions that I have on file with Caremark?

Your existing refills at Caremark will be automatically transferred to Medco, except for compound medicines and controlled substances. Members who use the Mail Service Pharmacy Program will receive additional information about prescription transfers in early December 2007. Members who have Mail service prescriptions for compound or controlled substances will need to get a new prescription from their prescribing doctor.

How do I know whether my prescription is for a compound medicine or controlled substance?

If you’re not sure whether your prescription is for a compound medicine or controlled substance, call the mail service Member Services toll-free at 1-800-262-7890. To access TDD service for hearing-impaired members, call 1-800-216-5343.

When should I request refills from Medco’s mail service pharmacy?

You should have at least a 14-day supply of medication on hand before requesting refills. Check your refill dates so that you’ll have plenty of medication when you submit your first refill request to Medco on or after January 1, 2008.

Can I order the rest of my refills from Caremark before the end of the year?

No. The Service Benefit Plan allows you to order prescription refills once 75 percent of your medication has been used. Check your refill dates so you’re sure to have at least a 14-day supply of medication on hand before you can submit refill requests to Medco on January 1, 2008.

What if I have a prescription that has expired or has no refills remaining?

You’ll need to get a new prescription from your doctor for any prescriptions that have expired or that have no refills remaining.

What’s the supply limit for my medication?

You can receive up to a 90-day supply of maintenance medication when you use mail service.

Will my medication(s) look the same?

If you use generic drugs, it’s the generic version that you receive from Medco that will look different than what you’re currently using. That’s because generic drug manufacturers sometimes use different inactive ingredients, such as fillers and dyes. Please be assured that no matter what your generic medication looks like, it will have the same active ingredient as its generic and brand-name counterparts. In addition, Medco uses a different type of medicine bottle than what you’re used to receiving from Caremark.

Will my medication(s) be shipped in the same way as they are now?

It’s possible that your medication will be shipped in different packaging than what you’re used to. However, Medco always uses appropriate temperature-protective packaging for every medication that requires it.

Has the Member Services phone number for mail service changed?

The mail service phone number has not changed. However, the TDD service for hearing-impaired members has changed to 1-800-216-5343.

Whom should I contact after January 1st if I have a question about a prescription that was filled by Caremark in December?

You can call Medco Member Services toll-free at 1-800-262-7890, which is the same number you use today. If Medco is unable to answer your question, your call will be directed to Caremark. To access TDD service for hearing-impaired members, call 1-800-216-5343.

Is there an additional charge for shipping and handling?

There’s no charge for standard shipping. Expedited shipping is available for an additional fee. If, however, expedited shipping is necessary because of a delay caused by Medco, there will be no charge to you.

What information will be transferred from Caremark to Medco?

The following information will be transferred to Medco:

• All open refills, except for compound medicines and controlled substances

• All prior approvals

• The last 12 months of prescription history for you and any covered dependents.

Will I continue to receive automated telephone messages about the status of my prescription orders?

Yes.

How do I pay for my mail service prescriptions I get from Medco?

You can pay by check, e-check, money order, or credit card. If you currently use a credit card for your Mail service prescriptions, you’ll need to contact Medco with your credit card information, as this information can’t be transferred from Caremark. Just call Member Services toll-free at 1800-262-7890. To access TDD service for hearing-impaired members, call 1-800-216-5343.

E-check is another term for electronic funds transfer. When you pay for Mail service prescriptions with e-check, your copayments are conveniently deducted from your checking account. Plus, there’s a 10-day grace period between the time your order is sent and when the amount is deducted from the assigned checking account. The amount that is being deducted will be included in the prescription information that accompanies your order.

IMPORTANT: If there are insufficient funds at the time Medco submits the funds transfer request, Medco will charge a $10 fee. Your bank also may charge an insufficient funds fee. If your account balance remains insufficient to pay the cost of your mail order after 60 days, your Medco account will be frozen until the balance is paid.

Does the HIPAA (Health Insurance Portability and Accountability Act of 1996) Personal Representative Authorization (PRA) form with Caremark transfer to Medco?

No. Due to HIPAA privacy regulations, your Personal Representative Authorization form on file with Caremark can’t be transferred to Medco. Therefore, you’ll need to submit a new PRA form with Medco. To get a new form, please call Medco Member Services at 1-800-262-7890. To access TDD service for hearing-impaired members, call 1-800-216-5343.

Information prepared by Blue Cross and Blue Shield Association and Medco.

Updated October 2007.