New Pharmacy Benefit Manager – Jan 1, 2019

As you are aware, John Carroll University has engaged HealthSmartRx/ExpressScripts, to be our new Pharmacy Benefit Manager (PBM) as of January 1, 2019.  HealthSmartRx/ExpressScripts will replace OptumRx in providing your prescription coverage.  Similar to OptumRx, HealthsmartRx/ExpressScripts has a wide network of pharmacies, including those that JCU employees currently use.  We are also maintaining the local network of pharmacies – the Regional network – that provides lower co-pays on generic medication and provide a 90 day refill of those generic medications at their retail locations.  The Regional network includes the pharmacies at Giant Eagle, Walmart, Marc’s, Discount Drug and others.

Starting this year, you will not need to carry separate cards for your medical and prescription coverage.  In the coming week, Medical Mutual of Ohio will be issuing new identification cards that will contain the information that you need to receive both medical and prescription services and as of January 1, 2019, will replace the existing MMO and OptumRx/Catamaran cards that you may have as proof of coverage.   Here is some important information to remember in this transition period:

1. While members recently received ID cards from HealthSmartRx/ExpressScripts, members will receive your new ID cards with combined medical and prescription info from Medical Mutual of Ohio prior to January 1, 2019. It is important to remember that until January 1, you will continue to use the existing coverage through OptumRx.

a. Beginning January 1, 2019 you can log in to the secure HealthSmartRx/ExpressScripts website http://www.healthsmartrxsolutions.com/members/ and access the “Member Portal”

b. You can call their member services line 24 hours a day at 1-800-681-6912 for help and assistance beginning in January.

1. If you currently have mail order prescriptions filled through OptumRx, you can continue to receive them via mail order from HealthSmartRx/ExpressScripts.  This is what to expect:

a. Visit Express-Scripts.com/Activate and sign in, or call them at the toll-free number on your member ID card. They will ask you for the information needed and will work with you to transfer your prescriptions.

b. If your script has no additional refills and/or is over 1 year old, you will need your physician to write a new script for you.

c. Prescriptions for newly prescribed medication presented on/after January 1, 2019 will be filled according to the new HealthSmartRx/ExpressScripts formulary tiers.

d. Prescriptions for specialty drugs will be filled from the HealthSmartRx/ExpressScripts specialty drug provider:  Accredo

e. Any specialty medications with open refills will be electronically transferred to Accredo from Briova. This process will begin prior to January 1, 2019 and will include outreach from Accredo via phone to individual members directly to complete.

3. On/after January 1, 2019 please contact HealthSmartRx/ExpressScripts if you have any questions or concerns about your drug plan, the pharmacy networks, your existing prescriptions, mail order, specialty drugs, etc.:

a. HealthSmartRx/ExpressScripts contact info:  http://www.healthsmartrxsolutions.com/members/

b. 1-800-681-6912 (available 24 hrs/day)

4. Remember: If you have questions now up through December 31 about your current prescriptions and fulfillment, you should contact OptumRx.

We are looking forward to working with our new HealthSmartRx/ExpressScripts and the new services, and options they provide.  If you have any concerns or need some help while the University is closed over the holidays, please feel free to contact me via cell or by email.

Ryan Armsworthy
Director, Total Rewards
John Carroll University
rarmsworthy@jcu.edu
216-386-2718 (c)