If you’re a Member of Community Health Options who’s struggling to pay for medication, skipping doses because of the cost, or just feel overwhelmed by trips to the pharmacy, our Care Management and Pharmacy teams may be able help.
Through our new Medication Synchronization Program, Community Health Options has begun to reach out to Members with three or more chronic prescriptions to arrange for a three-month supply of all their medications to be available at their local pharmacy at the same time.
And when it comes to cost, our Care Management and Pharmacy teams may be able to find ways for Members to save money. For instance, a Member with type 2 diabetes was recently reusing dull lancets to test her glucose levels. She also stopped filling her Ozempic prescription because it was just too expensive. As a result, her blood sugar shot to dangerous levels.
A Community Health Options pharmacist stepped in to help. She worked with the woman’s provider to get the prescription switched to mail order which brought the cost for Ozempic down to a more affordable price.
Our Pharmacy team is specially trained to evaluate Members’ situations for opportunities to save them money and ensure they’re taking medications as prescribed. For example, our ScriptSaver Program, launched in 2020, saved more than $157,000 in pharmacy costs in 2022.
“When we see a potential savings, we reach out to the Member,” says a Community Health Options’ clinical pharmacist. “It’s not just about informing them that we found a savings; it’s about going through the process with them, so they don’t have to do all the legwork alone.”
The opportunity for savings can be significant, and Members need only give our care teams the green light to work with providers and pharmacies to help reduce prescription costs. Our care teams also contact drug manufacturers to explore potential savings—a step many retail pharmacies don’t have time for.
To access these services, call our Maine-based Member Services team at (855) 624-6463, available from 8 a.m. to 6 p.m., Monday through Friday.
Once upon a time, anyone who needed immediate medical attention would head to the emergency room (ER). Today it’s important to know all the options available so that when a time of need comes, you're better prepared to get the care you need at a cost that won’t break the bank.
First, it’s important to say that, in cases of a medical emergency, dialing 9-1-1 or/and heading to your nearest emergency room is still the way to go. But, for less urgent needs, like a bad sprain or high fever, we recommend using an Urgent Care Center, which is available without an appointment and is typically less expensive than the emergency room. Review this list of Urgent Care Centers in New England or have it handy to familiarize you with the Urgent Care Centers nearest to you.
For even less urgent needs – like a chest cold that won't go away, or those times when a child needs a sign-off for a minor injury to play sports – you also have a telehealth option. Health Options offers Amwell® Urgent Care telehealth at $0 cost-share on all non-HSA plans and $64 and $0 after the deductible for HSA plans.
The Amwell telehealth platform makes it easy to talk to healthcare professionals trained in internal medicine, family medicine, emergency medicine, and pediatrics about non-emergency needs whenever you need. For even more ease, if your telehealth provider recommends a prescription, you can get refills or be prescribed new medication. Note: Some prescriptions, including controlled substances, cannot be prescribed online.
To get started with telehealth services, log into your Member portal, and click on the Health & Wellness tab. Once you've registered, your information will be stored for future visits. Telehealth makes access to care easy and affordable – no waiting room required.
