Frequently Asked Questions About Pharmacy Benefits

On Jan. 1, 2024, AdventHealth launched a partnership with CVS/Caremark to replace MedImpact as the pharmacy benefit manager (PBM) for our team member health plan.

The FAQs below may answer team members' questions about this new partnership and how it impacts their pharmacy benefit use.

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  • Question: Does AdventHealth’s new partnership with CVS/Caremark affect how I use my pharmacy benefit?

    Answer:

    No. This administrative change will not impact how you use your benefit. Rx Plus Pharmacy will continue to be your provider for maintenance and specialty medications. As the new PBM, CVS/Caremark processes team member claims for Rx Plus Pharmacy orders.

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    You will continue using your existing Rx Plus Pharmacy account while enjoying the same experience you have come to know and trust.

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  • Question: Am I required to fill my prescriptions through CVS?

    Answer:

    No. Rx Plus Pharmacy remains your pharmacy for filling maintenance medications, specialty drugs, and mail-order prescriptions. Prescriptions for maintenance medications must be filled with Rx Plus Pharmacy.

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    You may continue using retail pharmacies, such as CVS, Walgreens or another local retail pharmacy, to fill one-time medications like antibiotics.

    Maintenance prescriptions for controlled substances may be filled by your local retail pharmacy or Rx Plus Pharmacy.

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  • Question: What is the most efficient way to fill my current maintenance prescriptions?

    Answer:

    The most efficient way to fill a current maintenance prescription is online through MyAdventHealthRx.com by clicking on Refill Request.

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    You can order a refill of your prescription up to a month in advance, or you can opt into auto-refill services that will automatically initiate the processing of your refill 30 days before it is due by emailing [email protected]. Taking these steps will help to reduce delays you may experience.

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  • Question: Why am I experiencing delays in prescription fill times and customer service wait times at Rx Plus Pharmacy?

    Answer:

    The transfer to CVS/Caremark has created delays as the Rx Plus Pharmacy staff transitions members to the new plan, but these delays will be resolved shortly. Your patience is appreciated as the team works diligently to provide excellent care for health plan members.

  • Question: Do I need to register online to use my pharmacy benefit?

    Answer:

    No. You may disregard the sticker on your new pharmacy ID card, as online registration is not required for the pharmacy benefit. Your new CVS/Caremark pharmacy ID card is ready for use without further action, and your existing Rx Plus Pharmacy login remains valid.

  • Question: Do I need to submit a new prior-authorization (PA) for my medications this year? Are my current medications still covered?

    Answer:

    Medications covered by the team member's health plan may have changed or have a different copay. If these changes impact you, you will receive a letter explaining next steps, as you may need to coordinate a medication change with your prescribing health care provider.

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    Please note that weight loss and fertility drugs remain excluded from coverage.

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  • Question: How do I find out if my medication is covered?

    Answer:

    The formulary — a list of covered medications — is available on the Rx Plus Pharmacy website, where you can reference the full list of covered medications.

  • Question: Where can I access my member ID cards to use my pharmacy benefit at a local retail pharmacy?

    Answer:

    If you didn’t receive an ID card by mail, you can request one by contacting plan member support via email or phone: