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Beginning July 1, 2022, CVS Caremark will provide prescription drug benefits to UNM employees/pre-65 retirees and their families enrolled in UNM LoboHealth (administered by BCBSNM) and Presbyterian Health Plan. This transition is a result of a competitive procurement required under NM Procurement Code. This web site provides information and resources for UNM employees and families during Open Enrollment and transition to the effective date of July 1.
All participants will receive a CVS Caremark Prescription Drug ID Card by July 1 and will need to present the new ID card to the pharmacy when filling prescriptions beginning July 1.
No, you can go to any of the 68,000 pharmacies nationally that are in-network, including Walgreens, Smiths, and UNM Pharmacies. Use the CVS Caremark® Pharmacy Locator to check for your pharmacy, or call the dedicated UNM customer service line at 877.745.4394 to speak with a CVS Caremark Customer Care Representative.
UNM’s current prescription drug benefits, such as copays or coinsurance, are not changing. However, the CVS Caremark formulary may differ slightly from the current Express Scripts formulary, which means your medication could be at a different tier on CVS Caremark’s formulary. An online cost calculator will be available by UNM’s open enrollment period for you to check the formulary status and cost of your prescriptions.
Beginning April 20 at 8:00 a.m., call the CVS Caremark® Customer Care dedicated toll-free customer service number for UNM at 877.745.4394. CVS Caremark Customer Care will be accessible 24 hours a day, 365 days a year.
UNM’s plan will use the CVS Caremark Standard Formulary with Advanced Control Specialty. CVS Caremark updates the Standard Formulary quarterly. An online cost calculator tool that will be available on April 20 will provide you with real-time cost estimates at different pharmacies by zip code.
Yes. Prior to July 1, CVS Caremark will send you a notification letter if your current medication will be a higher tier or excluded from the Standard Formulary. The notification will include alternative medications that are on a lower tier on the formulary to help you save money.
After July 1, CVS Caremark will mail a notification letter to you if your drug changes tier status and results in a higher co-pay/coinsurance cost to you at any point during the plan year.
Existing prior authorizations will be transferred, effective July 1. Beginning July 1, you may have your physician contact CVS Caremark and request a medical review or prior authorization for your new prescriptions. Your physician can contact CVS Caremark via phone at 800-294-5979 or find additional information under the prior authorization section of www.caremark.com.
No immediate action is needed. Your current prescription will transfer directly to the CVS Specialty Pharmacy after 7/1/2022 for fulfillment. CVS Caremark will be sending you a notification letter with contact information and next steps prior to 7/1/2022. CVS Specialty can be reached at 800-237-2767 or online at https://www.cvsspecialty.com.
Yes, you will be required to utilize the CVS Specialty Pharmacy for all applicable specialty medications. Your prescriptions can be sent directly to you or you can elect to arrange pickup through a retail CVS location near you. There are exceptions for individuals who may be taking a specialty medication that is only available at certain pharmacies.