Pharmacy Benefit Administration
Medco has the nation's largest mail order pharmacy operation and was ranked #1 in the Wilson Rx® Pharmacy Benefit Manager (PBM) Member Satisfaction Survey from 2002 - 2007. Coventry Health Care, Inc. considers its contract with Medco to be the beginning of a strategic partnership. With Medco, members will have access to Therapeutic Resource Centers and increased web-based technology, including online cost comparison tools, links to Consumer Reports Best Buy Drugs, and email reminders about prescription refills. Over time, Coventry Health Care anticipates the ability to exchange utilization data with Medco, enhancing our ability to serve members with chronic medical conditions.
Some key points to this transition include:
Formulary - The formulary will remain Coventry Health Care, Inc.'s formulary. We will maintain the current process to communicate formulary changes. A flyer describing the formulary changes scheduled for 2010 has been posted on our website.
Network - The national pharmacy network includes over 62,000 pharmacies. We do not expect disruption to our members based on network availability.
Open refills - Coventry Health Care will work with Medco to transfer open refills on mail order and specialty prescriptions.
History - One year of claim history will be loaded at Medco to allow utilization review programs to run seamlessly.
Preauthorizations - Active preauthorizations will be loaded in the Medco system and will not require any action from members or providers.
Customer service - The phone number will be the same. Members can access the Pharmacy Customer Service Team at the number on their Member ID cards.
A detailed document related to the Medco transition has been posted on our website in the Broker section under Announcements and News. Member and employer communications related to the transition to Medco are scheduled to begin in October.
