CVS Caremark is HMSA's new pharmacy benefit manager
On January 1, 2013, CVS Caremark will replace Medco Health Solutions (now known as Express Scripts) as HMSA’s pharmacy benefit manager (PBM). CVS Caremark will process prescription drug claims for members who have HMSA drug coverage.
Note: Some employer groups contract independently with CVS Caremark to provide drug coverage that is not through HMSA. Members of these groups may have a separate CVS Caremark card. If you have any questions regarding your drug plan, please call the phone number on the back of your membership card.
How this affects your drug coverage
There will be no major changes to your HMSA drug coverage. Here is what you can expect:
- You will receive a new membership card. Your card will have new drug plan information that your local pharmacy will need to submit claims for prescription drugs. Your current card is valid until December 31, 2012. After that, please discard it and use your new card.
- If you are now using an HMSA participating retail pharmacy in Hawaii, you will not have to switch.
- For most members, your out-of-pocket cost for your prescriptions will not change. HMSA determines your drug copayments and unless your 2013 plan certificate has changed, you will continue to spend the same amount on your prescriptions.
- If you currently purchase prescription drugs through mail order, your prescription information will be automatically transferred to CVS Caremark. As of January 1, 2013, you can request refills by logging on to My Account on hmsa.com and selecting the Manage Mail Order Prescriptions tab or you may call HMSA’s Customer Relations department and select the drug option to speak with a CVS customer care representative. However, you will need a new prescription from your doctor if:
- Your existing prescription is for a controlled substance or a compound medicine,
- You have no refills remaining, or
- Your prescription has expired.
- The drug formulary for most HMSA drug plan members will remain unchanged. If there is a change to a drug you are taking, HMSA will notify you.
For more information on your drug coverage, please read: