Empire Plan Prescription Drug Program Update

On January 1, 2006, Empire Blue Cross Blue Shield (BCBS) and Caremark replaced Cigna and Express Scripts as vendors for the Empire Plan Prescription Drug Program. The following information is current as of 1/5/06.  

Retail Pharmacies

Empire BCBS/Caremark expected to contract with most of the retail chain pharmacies and independent pharmacies that were in the Empire Plan Pharmacy Network in 2005. If you have refills remaining at a local, retail pharmacy, check with the pharmacy to make sure it is in the network for 2006. If it is not in the network you would still be able to use the pharmacy, but your benefits would be significantly reduced and you would have to pay more out of pocket.

The first time you fill a prescription at a retail pharmacy after January 1st, it may be helpful to bring the following information:

Rx Group: NYSTATE

Processor Control Number: NYSTATE

Bank Identification Number: 004336

If the pharmacist has trouble submitting a claim to Caremark, there is a dedicated toll-free line for pharmacists:  1-800-364-6331. If the pharmacist incorrectly submits a claim to Express Scripts, s/he will receive a message indicating the claim should be submitted to Caremark.

Mail Service Pharmacy

If you previously used the Express Scripts Mail Service Pharmacy and had refills remaining, your prescription (except for compound drugs and controlled substances that will require a new prescription) were automatically transferred to the Caremark Mail Service Pharmacy as of January 1, 2006. The address for the Caremark Mail Service Pharmacy is:

Caremark

P.O. Box 3223

Wilkes-Barre, PA 18773-3223

Caremark Phone Numbers

Customer service                                          1-877-7-NYSHIP (1-877-769-7447) Choose the Empire Plan Prescription Drug Program on the main menu, then choose option 2.  

Dedicated toll-free line for doctors              1-877-727-7455

Toll-free fax line for prescriptions                1-888-891-6334

Caremark Website

As of 1/1/06, Caremark’s website was not recognizing members’ alternate identification number, which should have been loaded into their system. While Caremark is working to resolve the problem, a temporary solution is available. Members may register using their Social Security number, which the website will recognize, and gain access to the site. For those who prefer not to use their Social Security numbers, information posted on the website may be obtained by calling the Empire Plan toll-free at 1-877-7-NYSHIP (1-877-769-7447). Choose the Empire Plan Prescription Drug Program on the main menu, then choose option 2.  

More detailed information about the transition to Empire Blue Cross Blue Shield/Caremark is available in a special Empire Plan Report which was mailed to all Empire Plan enrollees in November. It is also posted on the Civil Service website www.cs.state.ny.us. Click on the Employee Benefits link, then Publications and Forms. Under Current Publications, choose the group PEF, then scroll down to select the Empire Plan Special Report, November 2005.

If you need additional assistance, please contact Health Benefits in Contract Administration at 1-800-342-4306 or 518-785-1900 ext. 283.