As a reminder, benefitexpress Version 2.0 became available on September 2. You may utilize the new version of benefitexpress (https://be.cvty.com) for groups with effective dates of December 1, 2009 and forward. Please continue to use the current benefitexpress for new sales and renewals with effective dates in October and November 2009.

Seasonal flu is not just a runny nose or upset stomach.  On the contrary, it's a serious illness that can lead to pneumonia or even death.  Coventry Health Care is encouraging members in groups identified by the CDC to get the seasonal flu shot.  Members can get coverage for the seasonal flu vaccine by going to their participating provider's office.  Members who have pharmacy benefits through Coventry Health Care may also choose to visit a pharmacy that is participating in the seasonal flu shot program.  If the vaccine is administered by a registered pharmacist at a participating pharmacy, not by a third-party flu clinic, members will pay a Tier One pharmacy copayment for the shot. 
 
Please note that the seasonal flu vaccine will not protect from the H1N1 flu virus.  Coverage for the H1N1 flu vaccine will be provided, in accordance with CDC guidelines, as it becomes available.  The government is covering the cost of the vaccine itself.  Authorized providers may bill for administration charges. Coventry Health Care will only cover the H1N1 vaccine for members who fit the criteria established by the CDC and listed below.  If eligible members receive the vaccine in a provider's office, and the provider does not charge for an office visit in addition to the administration, there will be no copayment for the administration charges.  If members receive the vaccine in a participating pharmacy, the applicable tier one copayment will apply toward the administration charges only.
 
Groups recommended to receive the seasonal flu vaccine are:  children aged 6 months up to their 19th birthday, pregnant women, people 50 years of age and older, people of any age with certain chronic medical conditions, people who live in nursing homes and other long-term care facilities, health care workers, household contacts of persons at high risk for complications from the flu, household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated).*
 
Groups recommended to receive the H1N1 flu vaccine are:  pregnant women, household contacts/caregivers for children under 6 months old, health care and emergency personnel, people between 6 months old and 24 years old, people between 25 and 64 years old who have health conditions associated with higher risk of medical complications from influenza.
 
Should members contract H1N1, Coventry Health Care will cover treatment of the virus and the required medications as long as they are prescribed in accordance with CDC recommendations.
 
For more information, visit www.cdc.gov or www.flu.gov.

MHNet has been providing behavioral health services since 1985 and is accredited by both NCQA and URAC.  MHNet's stated mission is to provide the highest quality behavioral health and substance abuse services to members through an integrated health care delivery system that produces consistent superior clinical outcomes, maintains member dignity, recognizes special needs and preferences, and offers affordable behavioral health care services in the least restrictive setting.

Member and employer communications related to the transition to MHNet are scheduled to begin in October.  The Customer Service number associated with behavioral health/substance abuse will remain the same with MHNet.

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.

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.

 

Communications Schedule
Brokers	Week of September 21, 2009
Employers	Week of September 28, 2009