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► List of Caremark Network Payers & Covered Lives
► Caremark Opt-Out Form
OPT-OUT DEADLINE IS MONDAY, APRIL 29!
Caremark has sent all Elevate pharmacies a direct solicitation to participate in the PBM's 2025 Medicare Part D network for all its Part D plans (and certain other plans) except those sponsored by Aetna/SilverScript. The Caremark 2025 Part D network encompasses 123 payers covering almost 6 million lives.
Several members have told us that the reimbursement terms offered in the Caremark contract are poor. We encourage each pharmacy owner to carefully review the terms of the Caremark contract offer and make your own decision about 2025 participation. You should review contract terms to determine if they may be below product acquisition cost and include vague payment terms such as Maximum AWP Discounts and Minimum Dispensing Fees, which will vary by plan sponsor. Also, be sure to carefully review all terms and conditions in the contract to determine if they are reasonable.
Caremark requires pharmacies that do NOT wish to participate in its 2025 Part D network to return a completed opt-form to the PBM on or before April 29, 2024. Pharmacies failing to opt out by that date will automatically be included in Caremark's 2025 Part D network. You cannot opt out after Monday, April 29.
The best outcome of this situation is for a great majority of pharmacies to opt out of the Caremark offer, forcing the PBM to negotiate better reimbursement terms with GNP's Elevate Provider Network to ensure an adequate 2025 network.
If you are an Elevate member, your decision to opt out will be superseded if Elevate reaches an agreement with Caremark and elects to enroll in the PBM's 2025 network. If you opt out of the 2025 contract, that decision does not affect your participation in any of Caremark's 2024 networks.
You should have received the opt-out form from Caremark, but here is a link to it if you need it.
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