CVS Insurance Changes (Express Scripts/Tricare)

Started by RxMember11
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RxMember11

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Hi, I'm wondering if someone could clarify some information regarding the recent split between Tricare and CVS. Is Express Scripts as a whole dropping CVS or just specifically the Tricare branch? I've also heard rumors about Florida Blue. Anyone up to date on the many insurance changes coming soon to CVS? Thank you!
 
RxMember11 said:
Hi, I'm wondering if someone could clarify some information regarding the recent split between Tricare and CVS. Is Express Scripts as a whole dropping CVS or just specifically the Tricare branch? I've also heard rumors about Florida Blue. Anyone up to date on the many insurance changes coming soon to CVS? Thank you!
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Tricare and Express Scripts wants everyone to get their drugs mail order. They offer $0 copays on generics and discounted co-pays on the rest. After that they have preferred retail pharmacies which I believe have a discounted copay schedule. I'm not sure if it's the same as mail order. Then there are non-preferred network retail pharmacies. For example as an independant I can fill Tricare prescriptions however they get charged a much higher co-pay. I have one retiree who fills here with Tricare. Express Scripts made them get everything through mail order for a year. Once the year was up they could opt out of mail order and get their prescriptions filled at my pharmacy with a higher copay. Then there are specialty drugs. Right now Tricare specialty drugs can only be filled retail at a Walmart or Target. So my retiree on Humira got all her scripts at my pharmacy then had to drive 45 miles round trip to get Humira at Walmart.
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Confused yet?
 
MountainPharmD said:
Tricare and Express Scripts wants everyone to get their drugs mail order. They offer $0 copays on generics and discounted co-pays on the rest. After that they have preferred retail pharmacies which I believe have a discounted copay schedule. I'm not sure if it's the same as mail order. Then there are non-preferred network retail pharmacies. For example as an independant I can fill Tricare prescriptions however they get charged a much higher co-pay. I have one retiree who fills here with Tricare. Express Scripts made them get everything through mail order for a year. Once the year was up they could opt out of mail order and get their prescriptions filled at my pharmacy with a higher copay. Then there are specialty drugs. Right now Tricare specialty drugs can only be filled retail at a Walmart or Target. So my retiree on Humira got all her scripts at my pharmacy then had to drive 45 miles round trip to get Humira at Walmart.
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Confused yet?
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ill say this much. other then my medicaid patients. the majority of my private plan patients are being forced to either mailorder or cvs / target under their mail or its ok to go to cvs plan. ive never seen so many refills not covered. rejections in my life. these people are like the mob with. but better. cuz they write the contract that we cant refuse to sign. shouldve been an electrician. fml
 
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