OptumRx – New Manager for a New Year


Starting January 1, 2020, OptumRx will be your new pharmacy benefit manager. There is no action required on your part, and this does not change your benefits for 2019. Through the end of the 2019 calendar year, you may continue to fill your prescriptions at any Catholic Health Initiatives pharmacy (available at select ministries), via CVS Caremark mail order or at a CVS Caremark network pharmacy (based on plan design).
When we make the change to OptumRx, you will have access to a large network of retail pharmacies, including national chains and local pharmacies and the ability to fill maintenance medications through mail order services. During the next few months, we’ll send you helpful information so you can feel confident managing your medications. Both CHI and OptumRx are dedicated to making this transition easy for you.

Here are three things you need to know about your prescription coverage for 2020:
1. The benefit plan design is not changing. The coverage amount is not changing. However, the formulary list will be updated as it is every year and you may see changes in cost because of that.
2. In mid-to-late December, your medical plan administrator will send you a new medical card with updated pharmacy information.
3. Specialty prescriptions must be processed through the CHI Health Specialty Pharmacy.*

We know that managing your pharmacy benefits can be confusing, so OptumRx will be ready to support you and provide the tools you need to navigate your pharmacy benefit. You’ll receive more information when our Annual Enrollment site opens on September 25. 

*1) Due to Arkansas state law, CHI St. Vincent members will fill specialty medications at the local CHI St. Vincent Pharmacy or the OptumRx specialty pharmacy, BriovaRx.
2) There may be situations that CHI Health Specialty Pharmacy cannot fill your Specialty medication, when that situation exists CHI Health Specialty Pharmacy will route the specialty medication prescription to OptumRx.