Pharmacy Benefit Manager Update

As the Jan. 1, 2020 implementation date approaches, we are in the process of several activities related to transition to OptumRx.

Upcoming Transition Communications

(Sample Copies are Linked in Each Section)

  • Transition Letters (Oct. 28 mail date) – These are introductory letters that will be sent to legacy small group and individual subscribers only. This letter outlines the key changes for all members: new ID cards, new mail-service pharmacy, new specialty pharmacy.
  • RX Updates (Late October):  We will have minimal changes to the covered drug lists for select members. Members who have a drug exclusion will receive a letter.
  • Group Leader Notifications (Late October): Information included in this bulletin will also be sent to group leaders for all our plans.

2020 Pharmacy Information:

2020 pharmacy networks and covered drug lists are available online:

Forthcoming Transition Communications 

November

  • Mail service and specialty letters: BlueCross BlueShield of South Carolina will send letters late in the month to all members using mail service and the preferred specialty pharmacy (separate mailings). This will serve as a reminder of the change and the need to contact the pharmacy on or after Dec. 2 to get set up in its system.
  • ID Mailing Heads Up: All members will receive a mailed postcard communication as a heads up to the December new ID card mailing.

December 

  • ID cards: All members will be mailed a new ID with updated pharmacy information to include the PBM Customer Service telephone number (more below). 

24/7 Customer Service Starting Dec. 2 

We have partnered with OptumRx to provide 24/7 customer support for pharmacy questions. Beginning Dec. 2, members can call PBM Customer Service.

Note: Newly enrolled members with Jan. 1, 2020 effective dates will receive our new ID card with the PBM Customer Service number listed on the back of the card. 

PBM Customer Service (including OptumRx Home Delivery)

This is the phone number for mail order, pharmacy help desk, and PA inquiries. This number can be provided to members.

  1. ACA Individual Marketplace: 855-823-0387 
  2. Small Group (ACA and Legacy): 855-819-0955 
  3. Individual Legacy: 855-819-0387

Date available: 12/2/2019

Hours of Operation: 24/7

 

BriovaRx

This phone number is for BriovaRx Specialty Pharmacy post 12/01:

877-259-9428

Date available: 12/2/2019

Hours of Operation: 24/7

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