01/03/2025
***UPDATE to the update!!**
I was able to get a contract emailed to me this morning and got it signed and returned. They have already activated Perkins Drug and we are back in the network.***
Contracting update. Today when we started processing prescriptions for SilverScript we started getting rejections for state retirees and employees. Despite being told on multiple occasions by my contracting agency that our Healthchoice/SilverScript patients would be covered, and that the letter from Caremark stating we were not in network was sent out in error... turns out they were mistaken and that we are currently not in network.
I have sent emails to Caremark today requesting a direct, independent contract but I am unsure how long this process will take. So, for now, we will do the best we can with the situation and attempt very fair cash prices or we can transfer your prescriptions to another pharmacy until we have some resolution. I apologize for this inconvenience; I was reassured no less than 5 times that we would definitely be in network on SilverScript. I was even told this morning when I called about the rejections, that it was an administrative issue within Caremark/Aetna that they were working to resolve the error. Then later today, I received an email stating:
"In December of 2024, you may have been informed that your state’s retiree group plan was contracted under our Aetna Medicare Part D contract for 2025. It has since come to our attention that these plans will actually process under the Caremark Medicare Part D 2025 Network for which we are not contracted. Unless you hold a direct Caremark Medicare Part D contract for 2025, you will be out of network for your state’s retiree group plans."
We are still contracted on the Med D SilverScript platform so we can do regular SilverScript, just specifically not the plan for retired teachers and state employees. It seems Caremark holds that specific contract under the Caremark side of their business, unlike the normal Medicare plan that is under the Aetna side of the business.
Steve