Download the FAQ for more information
Read about this change in the Spring issue of Community Health
Make the Most of your Pharmacy Benefits
Understanding your pharmacy benefits is crucial to making the most of your health plan and saving money. Review the information below for some important tips on using your existing pharmacy benefits from Highmark/Express Scripts, valid through June 30, 2022.
Your Prescription Drug Network
ACSHIC currently uses the Advantage network, which is part of Highmark/Express Scripts.
Beginning July 1, 2022, ACSHIC medical plan members will use the OptumRx network to fill prescriptions. The OptumRx network includes almost all of the same pharmacies, so your local pharmacy should not change. You will simply need to update your pharmacy on your first fill after July 1, 2022.
- You will have two separate ID cards as of July 1, 2022: a new medical card through Highmark and a pharmacy card through OptumRx. You will receive both cards in mid-June.
Stay tuned for more information about the OptumRx transition or download the FAQ here.
Through June 30, 2022, Highmark members can fill their Specialty Medication faster than mail order at over 200 Giant Eagle Pharmacy locations. If you are currently on a Specialty Medication, you have options on where you can fill your prescription.
Beginning July 1, 2022, any specialty medications will be transferred to OptumRx Specialty. You will receive a letter in May or June with information about this change, which should happen automatically.
An Integrity Pharmaceutical Advisors (IPA) concierge pharmacist can answer your questions about specialty medications at (866) 726-1180.
Mail Order Prescriptions
Your prescription benefit offers delivery of maintenance medications – those you need on a long-term basis – right to your door, with free standard shipping. (You should use a retail pharmacy for medications you take on a short-term basis, such as antibiotics.)
Beginning July 1, 2022, your mail order medications will be transferred to OptumRx. You will receive a letter in May or June with information about this change, which should happen automatically.
Protection from high specialty medication costs
Copay Armor is a specialty copay assistance program available from Highmark through June 30, 2022. Copay Armor, powered by PillarRx Consulting, leverages manufacturer assistance to lower prescription out-of-pocket costs for members on eligible drugs. Participating members with questions can contact the PillarRx team at (636) 614-3745, Monday-Friday, 7:30am-7:00pm EST, or the Highmark Concierge at (877) 258-3123.
Beginning July 1, 2022, specialty drug cost protections will be offered by the Variable Copay Program from OptumRx. Members on eligible drugs can sign up for a special copay card for some prescriptions – a “coupon” – which will help cover drug costs. You will be contacted by OptumRx if this program can benefit you.