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.
As great as New England is, we all must leave it occasionally. When we do, it’s reassuring to take great healthcare coverage along for the ride, which is why Health Options offers great plans with a national network option.
Kid in college in Santa Cruz? Cool. Regular business trips to Baltimore? No problem. Family cabin on Lake Champlain? Go you! Congratulations on making a wise choice on your healthcare options. Having a plan that travels with you across the country means you’re free to roam - and take your accident-prone teenager with you – no worries.
Community Health Options provides national in-network coverage through First Health®, a nationwide preferred provider organization (PPO) of hospitals, doctors, and other health care providers. This network includes approximately 6,100 hospitals, 130,000 ancillary facilities and 845,000 doctors and other health care providers. By choosing from this list of in-network providers when you travel, you can lower your total cost of care.
Having a national network is one thing, but it’s another to know how to access it. Instead of waiting until you break your ankle on a sidewalk 600 miles from home, learn a few basics now. Use the Health First online provider search tool. It’s simple and available 24/7 and includes detailed information.
Using your desktop or mobile device, go to https://providerlocator.firsthealth.com/mcho. Next, select a provider type from the options of Physician, Hospital, Urgent Care Center, Lab and Radiology, or All Providers and enter the ZIP code or State where you’re traveling. If you’re a nervous traveler, you may want to test this search function before you reach your destination. For example, a quick search of Urgent Care Centers within 10 miles of Beverly Hills results in 75 options.
Keep your Member card with you when you travel, remember these steps, or call First Health at 1-800-226-5116, and you’re good to go.
