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Benefit Updates 2024

July 1, 2024

Preferred Pharmacy Network Our Medicare Advantage* and Prescription Drug Plans offer a robust, dependable pharmacy network with over 60,000 pharmacies in network — many offering preferred cost-sharing!* A member’s cost-share may be lower when prescriptions are filled through one of our preferred retail pharmacies or our preferred mail-order pharmacy, Express Scripts.® However, members may have prescriptions filled at any network pharmacy. Walgreens,® CVS,® grocers, and select independents pharmacies remain within the preferred 2024 pharmacy network.
Amazon® is no longer a preferred pharmacy but remains in the pharmacy network.

Remember, some retail pharmacies offer both retail and home delivery options. If a member fills a prescription with a retail pharmacy that also offers home delivery, the retail cost share will apply, and pharmacies may charge a delivery fee.

Please utilize the Find a Provider tool to find an in-network pharmacy. This will also allow you to find an in-network pharmacy’s network status (standard vs preferred and if 90/100-day fill is offered). *Preferred pharmacy network not available for Wellcare D-SNPs.

Formulary Updates

Beginning January 1, 2024, MAPD members will be able to receive up to a 100-day supply of qualifying medications with each fill for non-specialty medications at all in-network pharmacies.

The formulary GLP-1 agonists Bydureon Bcise,® Mounjaro,® Ozempic,® Rybelsus,® and Trulicity® will require a prior authorization (PA) to confirm medically-appropriate use for the treatment of type 2 diabetes (not covered for weight loss, pre-diabetes, type 1 diabetes, or heart disease prevention). The PA applies to all new and existing users of GLP-1 agonists.

Effective January 1, 2024, Express Scripts Pharmacy® replaced CVS Caremark® as our preferred mail order provider. CVS Caremark Mail Order® is out-of-network in 2024.

For Existing Mail Order Users:

Most open prescription refills were automatically transferred to Express Scripts.® Refills of controlled drugs were NOT automatically transferred. Members will need to request new prescriptions from their providers.

Members who need new mail-order prescriptions may either:

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Y0020_WCM_134133E_M Last Updated On: 7/1/2024
On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. Learn more about this from Change Healthcare, or reach out to the contact center at at 1-866-262-5342.

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