WellCare to Transition Pharmacy Benefit Management to CVS Health


WellCare Health Plans has announced that it will transition its pharmacy benefit management to CVS Health.




Dec. 31, 2015

/PRNewswire/ -- WellCare Health Plans, Inc. (NYSE: WCG), a leading provider of managed care services for government-sponsored health care programs, announced today that it will transition its pharmacy benefit management (PBM) to CVS Health, the nation's second largest PBM company, effective

Jan. 1, 2016

. Beginning

Jan. 1

, CVS Health will administer pharmacy benefits and will process pharmacy claims for approximately 3.8 million WellCare members who participate in the company's Medicaid, Medicare and Prescription Drug Plan (PDP) programs across the country.

WellCare members will have access to a robust pharmacy network, including national pharmacy chain stores and local pharmacies. For a listing of in-network pharmacies and assistance with questions, members should call the customer service number on the back of their prescription ID cards or go to www.wellcare.com.

"WellCare is committed to improving the quality of care and services we provide to our members to help them live better, healthier lives," said

Laura Hungiville

, WellCare's chief pharmacy officer. "We are pleased to partner with CVS Health to provide a comprehensive network of pharmacies and clinical programs designed to promote better health outcomes for our members."

The clinical programs are designed to improve beneficiary medication adherence and use. The programs, which use a coordinated care approach that includes both plan members and providers, will help to eliminate potential drug therapy issues, gaps in care, and potential over- or under-utilization of medications.

Studies show that taking medications as prescribed, or medication adherence, is one of the most effective ways to fight chronic diseases like high blood pressure, diabetes and high cholesterol.


A recent CVS Health study published in the journal JAMA Internal Medicine found pharmacy networks that incentivize plan members to use specific in-network pharmacies are associated with improved medication adherence.


"We are pleased to support WellCare and their members starting in 2016," said

Jonathan C. Roberts

, president of CVS/caremark, the pharmacy benefit management business of CVS Health. "We believe that CVS Health's unique integrated model for pharmacy care will provide WellCare members with innovative, cost-effective pharmacy benefit management services that also help improve health outcomes."

In 2015, WellCare members were sent letters informing them of the upcoming PBM changes as well as new prescription ID cards. Members will need to provide their new prescription ID cards to their in-network pharmacies beginning in 2016.

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