Announcing a New Pharmacy Benefit Manager: OptumRx


View the notice on the Online Public Notices website

A pharmacy benefit manager (PBM) is a company the Division hires to process AlaskaCare pharmacy claims. OptumRx has been selected as the new PBM beginning January 1, 2019. Today, these claims are processed by Aetna and CVS/Caremark, and they will continue to process them through December 31, 2018. Medical, vision and dental claims will continue to be processed by Aetna and Moda, respectively.

Why is this changing? What does this mean for me?

Periodically, the Division competitively bids these contracts through a Request for Proposal (RFP). This gives us an opportunity to seek better service at lower cost for members and the plan. The new PBM contract will go into effect January 1, 2019. Over the next few months, you will receive information about the transition. Please carefully review any letters you receive and contact the Division if you have any questions.

Does that mean my pharmacy benefits will change?

Your pharmacy co-pays will remain the same, but you may notice some small administrative changes like the list of medications requiring preauthorization may change. The Division is working to ensure those changes are limited and members know ahead of time if they will be impacted.

The new PBM contract with OptumRx will go into effect January 1, 2019. For more information, see the Online Public Notice or read the full Email Newsletter.