BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina and CVS/caremark® are introducing the new Advanced Choice NetworkTM. This network is exclusive for all BlueCross and BlueChoice®Health Insurance Marketplace (Exchange) plans. CVS/caremark is an independent company that provides pharmacy benefit management and pharmacy services on behalf of BlueCross and BlueChoice.
Beginning Oct. 1, 2016, Blue EssentialsSM (BlueCross Exchange) and Blue OptionSM (BlueChoice Exchange) members must use pharmacies in the Advanced Choice Network. If members fill prescriptions at a non-participating pharmacy after Oct. 1, 2016, they will be required to pay the full retail price. APNS is participating in the Advanced Choice Network. This is a limited network.
Attached please find a listing that shows a claim count by zip code where there are excluded pharmacies. Your pharmacy has the opportunity to pick up some of these claims by being in network.
Members have already received a notification advising them of this change, which also includes a list of participating pharmacies closest to their homes.
See attached Excel file for more information.