On January 1, 2024, the Compass Rose Health Plan will be transitioning management of our pharmacy benefits from Express Scripts to Optum Rx®. Optum Rx is already the pharmacy benefits provider for Compass Rose Medicare Advantage and is one of the nation’s leading pharmacy benefits managers and is committed to putting members at the center of the pharmacy experience and making health care more connected. Our goal is to make this move as easy as possible.
Over the coming months Optum Rx will be sending information in the mail to welcome members and let them know what they can expect. Members will receive a welcome letter from Optum Rx in October.
Benefits to members
Here are some of the things you can expect from this change:
- Digital tools and access. You’ll have access to Optum Rx’s online pharmacy services directly through Optum Rx’s website and mobile app as well as through your myCompass account beginning January 1, 2024. Optum Rx gives you access to simple online tools, efficient ways to get prescriptions, and guidance to make better decisions about your health. Their easy-to-use online tools will help you manage your prescriptions, look up specific medications and review pricing options.
- Enhanced support. Not only will you be able to contact Optum Rx directly with questions or concerns about your medications, but you will also be able to reach out to UMR for prescription drug assistance.
- Access to a large network of pharmacies. You will have access to the Optum Rx Home Delivery pharmacy and a large network of retail pharmacies, including large national chains and many local pharmacies, including CVS and Walgreens. Plus, Kroger and affiliated Kroger pharmacies will be back in network.
We’re excited about the positive changes you’ll see with Optum Rx. Here is some information to help you prepare:
- New medication formulary. The Optum Rx Premium Prescription Drug List will be the new medication formulary for the Compass Rose Health Plan. Medications for most members won’t be impacted. If your medication is affected by the new formulary, you will be notified by mail in November. Some medications may be in a new coverage tier, while others may no longer be covered by the plan. Optum Rx will assist all members in helping them find a similar covered medication.
- New home delivery program. If you currently use Express Scripts or Accredo Home Delivery, your prescription refills will be automatically transferred to Optum Rx Home Delivery and Optum Specialty Pharmacy. For new medications in 2024, you will need to have your prescription order sent from your doctor to Optum Rx before it can be filled. Instructions for how to do so will be in forthcoming communication materials.
- New specialty pharmacy. Our specialty pharmacy will be switching from Accredo to the Optum Specialty Pharmacy.
- New member ID cards. The Compass Rose Health Plan will be issuing new health plan member ID cards for use in 2024 to include Optum Rx. You will need to present your new ID card to your pharmacy to ensure proper processing of your medication(s).
To learn more about Optum Rx, locate network pharmacies, learn if your medication is covered and more, please visit compassrosebenefits.com/OptumRx. If you have questions, please reach out to us at (888) 438-9135 8 am to 8 pm ET.