As you know, Health New England’s pharmacy benefit manager (PBM) transitioned from Catamaran to OptumRx in July 2015 as the result of a merger. The transition has been relatively seamless for our members, aside from the name change.

We are writing to let you know that OptumRx recently notified us that they are moving to a new shipping facility and making some updates to their portal and home delivery policies that may have some impact on Health New England members. OptumRx recently mailed letters to Health New England members who may be impacted to inform them of these changes.

The following is a summary of items that became effective on July 1, 2016:

• New Home Delivery Form – Effective July 1, 2016, members should begin using the new OptumRx Mail Order Pharmacy Form, which reflects the new shipping facility in Kansas. We have updated our public website and member portal with the new form.
• Member Profile Updates – Members who are either new to home delivery services or who have not placed a home delivery order in the past 18 months will need to enroll and complete their profiles on the pharmacy portal. To do this, members should sign into the MyHNE member portal and select “Pharmacy Benefits” in the Coverage drop down menu, or they can call the number on the back of their ID cards.
• New Credit Card Policies – OptumRx will retain one preferred active credit card per member. Members who need to update credit card information should call the number on the back of their ID cards. Orders over $500 will need to be authorized by the member before being processed. Members will not be able to utilize auto refill unless a valid credit card is on file. Members will be alerted on the pharmacy portal or in the mobile app if updated information is needed.
• Mail to Retail – Drugs containing certain ingredients (i.e. aerosols) are no longer eligible to be shipped, and must be filled through a network retail pharmacy. Members will need to contact their doctor for a new prescription, and have it filled at a network retail pharmacy.
• Automatic Refills – Some medications, including controlled substances and short-term medications, will no longer be eligible for automatic refills.

In addition to recent policy changes, OptumRx is pleased to now offer the following additional benefits to Health New England members:

• Hassle-Free Refill – The new hassle-free refill feature enables members to receive refills automatically. As an added enhancement, the prescriber is notified on behalf of the member when a renewal is needed.
• Reduced Shipping Rates – Members will save approximately 50% on the cost of expedited delivery options.
• Coordination of Benefits (COB) – Select members will now be able to use their secondary benefit for home delivery medications.
• Aides for Visually Impaired Members – Large print, braille and talking labels are available for visually impaired members.
• Flip Top Bottles – For members unable to open child-proof caps, flip top bottles will be available for easy opening.

Members who have specific medication or mail order questions should call the pharmacy number on the back of their member ID cards.

If you have any questions about OptumRx, please call your Account Representative or email sales@hne.com. Thank you.