CVS prescription changes won’t affect many

Jan. 14--A shift in the way a major pharmacy chain processes insurance claims with Blue Cross and Blue Shield of Alabama is expected to affect only a small number of local residents whose coverage comes via a program enrollment through healthcare.gov.

CVS Pharmacy announced earlier this week that its exclusion from a network managed by Prime Therapeutics will affect only plans that were enrolled via the Health Insurance Marketplace under the Affordable Care Act.

Prime Therapeutics is a pharmacy benefit management company that coordinates prescription care coverage between insured patients and prescription providers. CVS said in a press release that it "was not our desire or decision to be excluded from this preferred pharmacy network."

When CVS initially announced the change, some Alabamians who receive their medication through CVS mistakenly took the news to mean that their BCBS Alabama plans no longer would be honored at any of the chain's pharmacies.

But that's only the case for the relatively small proportion of Alabamians who have obtained their coverage directly through the federal health exchanges established by Obamacare. For anyone with an employee-sponsored group plan, nothing has changed between CVS and BCBS Alabama.

"CVS Pharmacy's exclusion from Prime Therapeutics' pharmacy network only affects BCBS Alabama plans that were enrolled in through the Health Insurance Marketplace established by the Affordable Care Act," CVS explained.

"... CVS Pharmacy continues to accept all commercial plans offered by BCBS Alabama, which are typically through large employers and other groups of over 50 participants. CVS Pharmacy also continues to accept all BCBS Alabama Medicare Part D plans."

Cullman County Commission on Aging Director Dusty Baker said the CVS announcement has not driven any new inquiries about Part D coverage.

"The only way I could see people being concerned about any aspect of it would be if they had to switch their Part D plans away from CVS, but that hasn't happened," he said.

"But fortunately, we have not heard from anyone with any questions or concerns, which is a good sign."

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