Mosquito Repellent Benefit

Texas now covers mosquito repellents for the prevention of Zika virus. The following notice describes claims processing, eligibility, and benefit information specific to the mosquito repellent benefit for the below programs. The last page of this document contains a prescription template for claims processing.

*Please see attached PDF for more information.

West Virginia Medicaid
Aetna Better Health of West Virginia

Effective October 1, 2016, CVS Caremark® will begin to administer the
prescription benefits for Aetna Better Health of West Virginia. Please
update or create plan member profiles to reflect the changes regarding
the following new plan adjudicating through CVS Caremark.

*Please see attached PDF for more information.

Effective 10/1/2016

FutureScripts® will continue to manage claims processing for members of IBC National Alliance plans. Effective 10/1/16 the BIN/PCN will route from Argus to RxCLAIM (Catamaran, an OptumRx company) for claims with fill date on or after 10/1/16. Claims with fill dates prior to 10/1/16 will continue to route to Argus platform. Pharmacies who comply with the processor information indicated below will make no changes, since this routing will be enabled via the standard network switches.

Effective 10/1/2016

FutureScripts® will continue to manage claims processing for members of IBC Commercial plans. Effective 10/1/16 the BIN/PCN will route from Argus to RxCLAIM (Catamaran, an OptumRx company) for claims with fill date on or after 10/1/16. Claims with fill dates prior to 10/1/16 will continue to route to Argus platform. Pharmacies who comply with the processor information indicated below will make no changes, since this routing will be enabled via the standard network switches.

*Please see attached PDF files for more information.

BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina and CVS/caremark^® are introducing the new Advanced Choice Network^TM. 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 Essentials^SM (BlueCross Exchange) and Blue Option^SM (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.