IngenioRx introduces new pharmacy network in 2021
Starting January 1, 2021, IngenioRx, the pharmacy benefit manager for our affiliated health plans, will make its new standard pharmacy network available to your patients. The standard network will be made up of about 58,000 pharmacies nationwide, including well-known national chains like Costco, CVS, Kroger, Sam’s Club, Target and Walmart.
With robust access, your patients can use any participating pharmacy across the country in the standard network to fill their prescriptions.
Network Notification Plan
Some of your patients covered by an Anthem Blue Cross and Blue Shield (Anthem) health plan may currently use pharmacies that are not in this new network. They’ll need to transfer their active prescription(s) to a network pharmacy to ensure there is no interruption of their coverage.
Prior to the network effective date, we’ll notify your patients by letter outlining the easy steps about transferring their prescriptions to another pharmacy in the network.
In addition, to help you easily send prescriptions to a participating pharmacy, upon the member’s effective date, we’ll include messaging via your patients’ electronic medical record. This message will appear if you attempt to submit a prescription to a pharmacy that’s not included in the standard network. This will ensure your patients’ prescriptions are properly routed to a network pharmacy and will help them continue to receive their medications worry-free.
If your patients would like to search for a network pharmacy prior to the new network effective date, they can log in to anthem.com, where instructions will appear with a helpful link to our online pharmacy search tool. They can enter their address/city/state or their zip code to begin searching.
Please refer to our helpful Frequently Asked Questions below for more details about the new standard network.
Frequently Asked Questions
What is the standard pharmacy network?
The standard pharmacy network is being added to the IngenioRx network portfolio, beginning January 1, 2021. The standard pharmacy network will be made up of approximately 58,000 pharmacies nationwide, including well-known national retailers and big-box stores. These include Costco, CVS, Kroger, Sam’s Club, Target and Walmart.
How will my patients who have used a non-network pharmacy and are moving to the standard pharmacy network be notified?
Prior to January 1, we’ll notify your patients who are currently utilizing a pharmacy that will not be part of the standard network on the effective date via letter. The information will help patients easily transfer their prescriptions to a participating network pharmacy with no interruption when they need to fill their prescriptions.
How will I be notified if an ePrescription is routed to a non-network pharmacy?
An alert will be provided to you via your patients’ electronic medical records if you attempt to forward a prescription to a pharmacy that doesn’t participate in the standard network. This will ensure your patients’ prescriptions are properly routed to a network pharmacy and this will help them seamlessly receive their medications.
If I’m alerted through my patients’ electronic medical record that a pharmacy will not be part of the standard network, how can my patient move their prescription to another participating pharmacy?
You can choose another pharmacy in the patient’s EMR where the ePrescription will be routed, or your patient can take a printed copy of your prescription to the new pharmacy of their choosing and ask the new pharmacy to contact the non-network pharmacy to make arrangements for the transfer.
How can my patients search for a pharmacy that participates in the standard pharmacy network?
Starting in November 2020, your patients can log in to anthem.com, where information about their new pharmacy network will appear. The information will also outline how to transfer prescriptions to a network pharmacy with a helpful link to our online pharmacy search tool. They can enter their address/city/state or their zip code to begin searching.
Can my patients obtain maintenance medications at a standard network pharmacy?
While pharmacies in the standard network often fill prescriptions for both acute and maintenance medications, we encourage your patients who will be moving to the standard network in 2021 to use home delivery or their 90-day retail benefit after January 1, 2021, such as Retail 90 or Rx Maintenance 90, depending on their benefit design, to fill prescriptions for maintenance medications and possibly save on their out-of-pocket cost.
If my patients have questions about the new standard pharmacy network or need help with having their prescriptions transferred, whom should they contact?
If your patients have questions, they can call Pharmacy Member Services at the phone number on their member ID card.
January 2021 Anthem Provider News - Wisconsin