Are you being forced to use mail order?

We have been hearing some issues pop up on this so we wanted to send it back out again.  Members for NY Oxford groups (small and large) are not required to use Mail Order, they are being gently nudged to do so.   If they want to opt out they can either call the Oxford number on their card or log into the oxford website.  Here is the information from Oxford again:

 

We are extending the Mail Service Member SelectSM program to our Oxford fully insured commercial group members in New York, effective October 1, 2015. The program will be implemented with these members beginning on their group’s renewal date, on or after October 1, 2015. Mail Service Member Select is intended to help members better manage the medication they take on a regular basis through use of the OptumRx® Mail Service Pharmacy. Oxford New York self-funded clients are not affected at this time, although they may elect the program at renewal. Additionally, Mail Service Member Select is not available in New Jersey or Connecticut. 

 

Communications

  • Employers: In addition to the postcard mailing approximately 45-days prior to the affected customer’s renewal date with us, and Account Management email outreach, this information will be posted to the Messages section of the oxfordhealth.com Employer portal. The employer flier will be posted to the Tools & Resources section of the oxfordhealth.com Employer portal.
  • Members: Approximately 30-days prior to the affected group’s renewal date with us, we will inform members who are taking a maintenance medication about the Mail Service Member Select Program.

 

Attachments

  • Broker eBulletin
  • Employer Postcard
  • Employer Flier

The program requires members to make a choice – switch to mail service or stay at retail pharmacy

∙       OptumRx will promote the value of Mail Service (Convenience, Safety, Potential Savings and Adherence)

∙       This is NOT mandatory mail and NO financial penalties for staying at retail

 

Members allowed to fill prescription twice at retail pharmacy while they decide

∙       Initial notification of program and value of mail service sent 30 days prior to effective date for existing customers

∙       Multiple communications with members instructing them to contact OptumRx

∙       At any time, members can move to mail or disenroll from program by either calling customer service or via the web

 

If member has not notified OptumRx by third fill of a prescription, the pharmacist will instruct member to contact OptumRx before the prescription can be filled

∙       Once member contacts OptumRx and chooses mail service or retail, the third fill prescription can be completed real-time

∙       If member switches to mail, OptumRx will provide a one-time 30 day fill to allow enough time until first OptumRx fill arrives in mail”