Prescription Drug Benefits

Pharmacy is often your employees' most-used benefit, so it's important to provide them with the best experience possible. To ensure excellence, we've focused on these key concepts to better support you and your employees.

The right access for your organization and employees

We offer a large network with more than 65,000 pharmacies nationwide and more than 2,000 pharmacies in Michigan. With an eye on the right access, our goal is to maximize savings and convenience for you and your employees.

As part of that, we support health care providers with improved pharmacy technology so patients get the most appropriate and economical medications available. We also encourage members to enroll in home delivery because it's more affordable and convenient.

Though we offer the largest network in Michigan, we're vigilant in safeguarding you and your employees' access. We're committed to protecting your health care investment and have conducted fraud investigations that recently netted $34 million in savings.

Improved care for individual needs

We promote clinically sound, cost-effective medications for positive therapeutic outcomes​. Here's how: 

Formulary management​

To understand what the most effective medications are we have joint committee reviews and extensive monitoring. We also evaluate clinical effectiveness, side effects and offer low-cost benefit options.

Utilization management​

We're continuously evaluating the medical necessity, appropriateness and efficiency of health care services and medications​ to ensure their effectiveness. We do this through programs like step therapy, prior authorization and quantity limits, which has amounted to more than $310 million in savings in 2019.

Specialty ​pharmacy care​

We provide management of medications that are either high cost, high complexity or high touch​. This helps reduce your costs and improve your employees' health.

Medication adherence

Medication adherence can have a positive impact on the quality and length of your employees' lives. We encourage our pharmacy members to take their medications as prescribed. This is communicated through automated text and email reminders for prescription refills, consolidated pharmacy fills and coupons and copay assistance.

Plan understanding and engagement

All our programs work to lower costs and improve care, but they only work if your employees can find and use them with ease. We ensure your employees use and see the value in the benefits you provide them. 

In fact, we've raised the bar on the member experience by providing personalized, proactive guidance the entire year to educate, enable and influence member actions. 

With our member-first approach, you can be sure that your employees can use their pharmacy benefits in an easy, useful and personal manner.

Informed decisions for your organization

We understand your employees need help getting the right care, but we also understand that you look to us for insights and guidance. 

Our team of account managers, group customer advocates, data analysts, consultants and utilization and payment integrity professionals are at your service. We all work together to anticipate your needs and intervene on your behalf. 

As a team, we're committed to meet and exceed your organization's health care needs.