As of January 1, 2023, the Trust will partner with a new pharmacy benefits manager (PBM) WithMe Health. With the continual rise in drug cost, the goal of this partnership is to stem the increasing prices, through greater transparency, as well as a new pricing model that more accurately and fairly sets the cost of drugs. This change will not affect members’ pharmacy copays. Those will continue to remain the same as provided in the Plan documents. Additionally, all Trust members will continue to have access to the national pharmacy chains and supermarkets as well as most other pharmacies they have utilized in the past.
NEW ID CARDS
With the change to WithMe Health, all Trust members will receive new ID cards. The new cards will include the new information your pharmacy needs to process prescriptions. In order to have a smooth transition, and avoid any delays in services or prescriptions, it is imperative that all members bring their new ID cards to their providers’ offices and their pharmacies beginning January 1, 2023. (The old cards will no longer work and will be rejected at the pharmacy. We want this process to be as easy and stress free as possible, so please help us by presenting your new cards.)
NEW MAIL ORDER PHARMACY
Effective January 1, 2023, our new mail order pharmacy will be Manifest Rx. They will be administering our mail-order prescriptions. Upon your first order with Manifest Rx, you will be able to confirm/update your address as well as add a method of payment via secure text messaging. You will be able to choose whether you want to store your credit
card information in the Manifest Rx system. If you used ProAct mail-order pharmacy last year and have refills remaining, Manifest Pharmacy already has your information! A Manifest Pharmacy team member will be reaching out to you via text message or email prior to your refill being due. If you have a new prescription you would like to have delivered to you, or if you’d like to get started right away, as of December 1, 2022, you can call 888-770-4009 to speak to a Manifest Pharmacy team member or use the online site to send information securely. (Instructions and information on this will be sent soon to all members.) You can also have your prescriber send your prescription to Manifest Pharmacy via fax, phone, or electronic prescription. To do this please share the following information with your doctor:
Escribe: Manifest (NPI 1811205081)
As a reminder, please note as per the Plan document, Trust members are required to use mail order on any maintenance drug filled, after the third fill. This service is tailored to our members who take medications to treat chronic conditions. Our members can have prescriptions delivered directly to their door – at no extra cost.
NEW SPECIALTY DRUG PHARMACY
For specialty drugs, Lumicera Health Services will become our new specialty drug pharmacy and will be administering our specialty drug orders, effective January 1, 2023. Current and new users of our specialty drug program will need to setup a profile and provide payment information with Lumicera Health Services. Specific information on how to setup a profile and transfer prescriptions to Lumicera Health Services will be shared directly with all members that are currently impacted.
The Trust will continue to work will CanaRx. The new PBM, mail order, and specialty drug changes will have no impact on our current CanaRx program. Members should continue to utilize CanaRx for select drugs listed on the CanaRx formulary. Our partnership with CanaRx continues to help members and the Trust save money on brand name prescriptions while maintaining “no cost” prescriptions to the members utilizing this service.
CanaRx is a prescription broker who provides Brand Name medications in the original factory sealed manufacturer's packaging, deliver direct to your door with $0 co-pay from Tier I certified pharmacies in Canada, the United Kingdom, and Australia. It saves the Trust money (an average of 50%) and there is no member co-pay (a savings of $240 each year).
CanaRx is a voluntary prescription service for Brand Name maintenance drugs (90 day supply) where there is no-copay. It does not offer generic drugs. As with all maintenance drugs, after three monthly local retail refills, members must use mail order for the drug or will be penalized.
If a Brand Name maintenance drug is available through CanaRx and the member does not use CanaRx and refills through Manifest or another pharmacy, the penalty will be assessed. Members are responsible for checking to see if their Brand Name maintenance drug is available from CanaRx. For a list of available CanaRx Brand Name drugs, go to www.ktfmeds.com.
Proof of previous successful use of the drug is mandated for CanaRx, either by a 30 day purchase from a retail pharmacy or verification from your provider who can fax the request to CanaRx.