The new plan year for CU’s health plans began July 1, with small and large plan coverage changes for many enrolled employees and their covered family members. One of the most significant changes this plan year impacts Anthem plan members.

Prescription medicine coverage on Anthem-administered plans is managed by CVS Caremark. The changes that took effect July 1 apply to maintenance and specialty medications for anyone enrolled in CU Health Plans Exclusive, Extended or High Deductible.

Members enrolled in CU Health Plan Medicare are exempt from this change and can continue to fill their prescriptions at the pharmacy of their choice.

Understand CVS fulfillment changes

It’s important for Anthem plan members to understand what type of prescriptions they currently have. This chart outlines the fulfillment options and the allowed prescription types that can be filled at each.

One-time or short-term prescriptions — no changes

• For those filling one-time or short-term prescriptions, such as antibiotics, you may continue to fill your prescriptions at any CVS Pharmacy or CVS Retail Network Pharmacy — a national network of 68,000 locations including all major chains, supermarket pharmacies, Walgreens, community pharmacies and more.

Maintenance and specialty medications

• Anyone taking long-term maintenance prescriptions — such as those for diabetes, high blood pressure, etc. — will be required to fill those prescriptions from a CVS Pharmacy location (including those inside Target stores) or by mail through the CVS Caremark Mail Service Pharmacy.
• Anyone taking specialty prescriptions — typically medications to manage complex conditions — will be required to fill those prescriptions through a CVS Specialty Pharmacy.   
• These prescriptions can no longer be filled through UCHealth’s mail order pharmacy.

How to transfer your prescriptions

Enrolled plan members should begin moving their maintenance and specialty prescriptions as soon as possible. CU Health Plan members will receive up to three grace refills in the new plan year (or whenever new maintenance medications are prescribed in the future) before medications must be transferred. After those three refills, medications will not be covered, and you will have to pay 100% of the prescription cost.

For maintenance prescriptions

• To pick up prescriptions at a CVS Pharmacy: If you currently use a retail network pharmacy other than a stand-alone CVS Pharmacy (or a CVS Pharmacy inside a Target), you can transfer the prescription to a CVS Pharmacy retail location by visiting Caremark.com and entering in the medications you take regularly, and CVS will transfer them to the new CVS pharmacy of your choice for you.
• To have prescriptions mailed to you: Visit Caremark.com/MailService or call CVS Caremark Customer Care at 1-888-964-0121 to request that CVS Caremark contact your doctor for a new prescription.
  • Alternatively, you can ask your doctor to send an electronic prescription to CVS Caremark Mail Service Pharmacy. You can expect to get your medication within 10 business days. (Your doctor should select the following for electronic prescriptions: CVS Caremark MAILSERVICE Pharmacy, One Great Valley Blvd, Wilkes-Barre, PA 18706)

For specialty drugs

• A CVS representative will call you to set up your account and to help ensure the transfer of your prescription goes smoothly.
• If you haven't spoken to a CVS representative, you can call them at 1-855-299-3262, from 5:30 a.m. to 7 p.m. MT Monday to Friday.
• Visit CVSspecialty.com/GetStarted to learn more about CVS Specialty. 

Coverage change for insulin, generic diabetic drugs and supplies

• CU Health Plan enrollees with diabetes may qualify to receive insulin, generic diabetes medication and supplies (such as test strips, lancets, needles, etc.) from in-network pharmacies with no copay.
• For brand-name medication and supplies, enrollees will pay the applicable cost shares as outlined by their medical plan coverage.

Over the summer and early fall, Employee Services and CVS will send letters and additional communications to help you move your prescriptions. Visit our Pharmacy web page for more details on where to fill prescriptions, FAQs and more.