Highmark: ACA Members asked to Select Home Delivery for Maintenance Medications

Highmark issued letters to individual and small group ACA members in central, northeastern and western PA who filled a maintenance prescription drug in the last 120 days about the Active Choice Program by Express Scripts.

The purpose of the letter is to:

  • Inform members who are taking maintenance prescription medications that they will need to make a choice on how to receive these medications.
  • Provide cost savings and convenience examples supporting the home delivery choice.

Under the Active Choice program, a member must declare a choice to have their maintenance prescriptions filled either by home delivery through Express Scripts PharmacySM or to pick up their prescriptions at a local retail pharmacy.

Members have up to two fills at a retail pharmacy before they are required to make their choice. By the 3rd fill, the member will need to make a decision, or pay 100% of the drug cost. They will continue to pay 100% of the cost until their choice is made.

There is no penalty if members choose to continue to refill their maintenance prescription drugs through a retail pharmacy, and members can change their preference of retail pharmacy fills or mail order delivery at any time by contacting Express Scripts. Members will continue to get short-term medications, such as antibiotics, from participating retail pharmacies – no choice is required for short-term medications.

DISCLOSURE

The information provided herein is intended solely for the use of our clients. You may not display, reproduce, copy, modify, license, sell or disseminate in any manner any information included herein, without the express permission of the Publisher or Publishers of articles within.

The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.