Anthem 2020 Pharmacy Updates
IngenioRx is Anthem's new pharmacy benefit manager (PBM) as of January 1, 2020. Below are some updates your clients can expect this year as the transition to IngenioRx continues.
Will there be new ID cards?
The majority of existing Anthem members have already received new ID cards, which contain all of the information needed to process claims and access member service. Updated ID cards will include the following for Pharmacy:
- Bin: 020099
- PCN: IS
- Group No: WLHA
Are there changes to the formulary?
No changes. Anthem will continue to utilize the Select Formulary Drug List. (Formulary List)
What will members who use home delivery need to do?
Members will begin to fill home delivery prescriptions through the IngenioRx Home Delivery Pharmacy. If they have active refills, those prescriptions will be automatically transferred to IngenioRx.
- For security reasons, payment information will not transfer to IngenioRx. Anthem will explain to them how to reenter that information on their health plan website.
- Prescriptions for controlled substances and compound medications cannot be transferred. As a result, Anthem will explain that individuals filling these prescriptions at home delivery will have to contact their provider for a new prescription.
- Individuals who are currently enrolled in the “auto-refill” program with Express Scripts home delivery will have to restart their auto-refills after their move to IngenioRx. Anthem will instruct these members to visit their health plan website or call the pharmacy member service number on the back of their ID card in order to reestablish their auto-refill program.
What will members who use specialty drugs need to do?
- Members who fill specialty medications through Accredo will begin to fill those medications through IngenioRx Specialty Pharmacy. If they have active refills, those prescriptions will be automatically transferred to IngenioRx.
- Existing members with specialty drugs through Accredo, should have received a letter walking them through the move.
- Additionally, every member who fills a specialty drug will be contacted by Anthem's Specialty Care Team, via telephone, to introduce them to IngenioRx, check in on their care, and help them with the move to IngenioRx.
Is there a Customer Service Number for IngenioRx?
Yes, members can call the number on the back of their ID card. The Customer Service number is (855) 383-7248, press 1 for IngenioRx.
Home Delivery and Maintenance Drugs
Depending on the health plan a member has with Anthem, they may need to fill maintenance drugs through home delivery or an Rx Maintenance 90 pharmacy. Maintenance drugs are medicines used for long-term health conditions like asthma, heartburn, high blood pressure, allergies, and high cholesterol.
- Maintenance Drugs will need to be filled through Home Delivery after the 3rd retail pharmacy refill.
- View the list of home delivery/maintenance drugs
Retail 90
Through Retail90, employees can choose to get a 90-day supply of any covered medication from a participating local retail pharmacy. That includes prescriptions for maintenance medications, those taken on an ongoing basis for conditions like asthma, diabetes or high cholesterol. This means they can choose face-to-face personalized service from a local pharmacist.
- Anthem utilizes the National Pharmacy Network for Retail 90
- View the complete listing
Member Pharmacy Tools
It’s the fastest and easiest way for members to get all of their personalized pharmacy benefits information. At anthem.com/ca, they can do things like:
- Find a pharmacy.
- Check their drug list.
- Compare drug costs.
- Switch to home delivery or refill a prescription.
- Check their claims status and history.
- Check their copay, deductible or coinsurance amounts.
There’s an app for all of that, too. Anthem's new Sydney App makes it easy to manage pharmacy benefits from anywhere. The Sydney App can be found at the Apple Store® (iOS) or on Google Play (Android).
For questions, please contact a member of your B&P Sales Team - 888.722.3373.