TEMPORARILY your pharmacy was able to process claims for all Aetna Part D plans at CVS/Caremark Medicare Part D Network 12 and CVS/Caremark Medicare Part D Extended Days Supply Network 12 in network reimbursement rates. TEMPORARY ACCESS was effective for claims dating back to January 1, 2015. Please be advised that your TEMPORARY ACCESS for certain plans is through March 31, 2015.

This means that effective April 1, 2015 your pharmacy will receive Reject 40 (out-of-network) notices for claims submitted for the Standard and Standard Preferred Networks (Please download the PDF file listed below for more details).

Generics for Testim® and COLCRYS are available in the marketplace; however, effective immediately, select Medicare Part D plans adjudicating claims through CVS/caremark will continue to cover only the BRAND NAME products. The generic products, testosterone gel and colchicine,USP, will be non-formulary. Please continue to dispense brand name, Testim® and COLCRYS.

If claims for the generics are submitted, the following reject will occur:

Reject 70 <<Product/Service Not Covered – Plan/Benefit Exclusion >>

Effective February 17, 2015, generic for Nexium® 20 and 40 mg capsules became available in the marketplace; however, due to limited supply of the generic, select Medicare Part D plans adjudicating claims through CVS/caremark will continue to cover only the BRAND NAME product. The generic product, esomeprazole magnesium, will be nonformulary. Please continue to dispense brand name, Nexium®.

If claims for the generics are submitted, the following reject will occur:

Reject 70 <<Product/Service Not Covered – Plan/Benefit Exclusion >>

Late February 2015, generic Nexium® (Esomeprazole) will become available to the market. Esomeprazole will remain Non-Formulary for Medicare Part D Covered Persons and reject at point of sale (POS). The innovator product Nexium® will continue to be covered without prior approval* from the plan.

Your pharmacy may have received NCPDP Reject 65 (Patient is Not Covered) when attempting to process some Google member claims from Jan. 1, 2015 through Jan. 5, 2015.