New Pharmacy Benefit Manager Coming in 2022

Nov 8, 2021 | 2021, Access, Network

Effective January 1, 2022, Sutter Health Plus is changing its pharmacy benefit manager (PBM) to CVS Caremark® from Express Scripts®. CVS Caremark will manage the pharmacy benefits for our members, including retail, mail order and specialty prescription drugs; claims processing; and prior authorization requests for drugs.

CVS Caremark is collaborating with Sutter Health Plus to make sure our members get the right prescription drugs at the right time. We are confident that CVS Caremark will provide high-quality coverage and service while helping manage prescription drug costs.

In early January 2022, members will be able to create an individual account on the CVS Caremark member portal at caremark.com for access to many tools to help them understand the formulary and cost share options, including:

  • View order and drug history
  • Order refills online
  • Automatic refill reminders for all of prescriptions (retail, mail order, specialty)
  • Set communication preferences, for example email or text
  • Check order status and track shipments
  • Delivery of drugs within the United States, Monday through Friday, at no additional charge with most supplies provided, e.g., needles and syringes
  • Safety checks to help prevent interactions with other drugs and products
  • Access to specialty-trained pharmacists and nurses 24 hours a day, 7 days a week
  • View claims information

Teams across Sutter Health Plus and at CVS Caremark are currently collaborating with the goal of ensuring this transition is as seamless as possible for members. For more detail about the transition, visit the Sutter Health Plus Pharmacy page.

About CVS Caremark
CVS Caremark is one of the largest PBMs in the United States and serves over 105 million members across all 50 states, Puerto Rico, and the Virgin Islands. Learn more at caremark.com.