Close Close

Life Health > Health Insurance > Health Insurance

Anthem Medicare Advantage Plans Add CVS OTC Products Coverage

Your article was successfully shared with the contacts you provided.

At least three units of Anthem Inc. today announced that their Medicare Advantage plans will add the CVS Pharmacy chain to their over-the-counter (OTC) product provider network.

The deal means that enrollees in those plans can use their OTC products allowance to buy OTC drugs and health-related products from CVS stores.

(Related: CVS, Aetna Closed Their Deal. A Judge Is Not Happy)

The list of Anthem units announcing new OTC provider relationships with CVS includes Anthem Blue Cross of California, Empire BlueCross and Empire BlueShield of New York, and Amerigroup of New Jersey.

Anthem Inc. — the parent company — is an Indianapolis-based company that holds the Blue Cross license, the Blue Shield license, or both in 14 states. It provides or administers health coverage for about 39 million people.

The Medicare Advantage program gives private carriers a chance to provide an alternative to traditional Medicare coverage, with a combination of money from the federal government and premium revenue from enrollees.

In 2018, Anthem units were providing Medicare Advantage coverage to about 680,000 people, according to data from Mark Farrah Associates.

The three Anthem Inc. units that announced new OTC provider network relationships with the CVS pharmacy chain all said that “many” of their 2019 Medicare Advantage plans offer a “significant OTC allowance.”

Here’s how each unit described its maximum OTC allowance:

  • Anthem Blue Cross (California): “As much as $135 per month” (or $1,620 per year).
  • Empire (New York): “As much as $960 annually.”
  • Amerigroup (New Jersey): “As much as $135 per month” (or $1,620 per year).

CVS and Aetna

CVS Health Corp., the parent of the CVS Pharmacy chain, is also the parent of the CVS Caremark pharmacy benefit management company.

It recently completed efforts to acquire Aetna Inc.

One question has been how eager other health insurers would be to do business with CVS, once CVS was the parent of Aetna.

Anthem is the second major carrier to announce a significant expansion of its relationship with CVS this month.

Earlier this month, Molina Healthcare Inc, a California managed care company, announced that it had extended its PBM relationship with CVS Caremark through 2021, after conducting a “comprehensive procurement process.”

Molina provides or administers health coverage for about 4 million people through Medicaid plans, Medicare plans and individual major medical plans sold through the Affordable Care Act public exchange system.

— Read 2019 Life, Health and Annuity Planneron ThinkAdvisor.

— Connect with ThinkAdvisor Life/Health on LinkedIn and Twitter.