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CAREFIRST MEMBERS

Reminder about Capital Rx mail order and specialty pharmacy changes

On July 1, Costco Pharmacy will replace Optum Rx as the in-network provider for mail order and specialty medications

Pharmacist looking at items in a drawer to fulfill an order

Credit: GETTY IMAGES

Faculty and staff who are currently enrolled in a Johns Hopkins University CareFirst health plan will experience a change to the mail order and specialty pharmacy services provided by Capital Rx. Effective July 1, Capital Rx will switch from Optum Rx to Costco Pharmacy as the in-network provider of mail order and specialty prescriptions.

Transferring your prescriptions

If you currently have active prescriptions filled by Optum Rx, Capital Rx will reach out to you in June with a letter and a phone call, which will allow you to speak with a customer care agent for support with the transition of your prescriptions.

Most currently open active prescriptions with Optum Rx will be automatically transferred to Costco Pharmacy. Those that will not include:

  • Expired prescriptions
  • Prescriptions for controlled substances
  • Prescriptions with no refills remaining
  • Prescriptions that are new or renewed that were not filled
  • Compound prescriptions
  • Prescriptions from a local retail pharmacy

You must take action to transfer these prescriptions. In late June, Capital Rx will reach out with instructions on how to create your Costco Pharmacy account, add your delivery and payment information, and transfer your prescriptions. Starting July 1, you'll be able to set up your online member profile with Costco Pharmacy.

What if I need help?

Quantum Health, your free health care navigator as a CareFirst plan member, can assist you. Its representatives can answer questions about coverage, locate a pharmacy, or find the lowest-cost options for a drug. They also can reach out to your provider to request a refill or a different formulary option. Contact Quantum Health care coordinators at 844-460-2801, Monday through Friday, 8:30 a.m. to 10 p.m., or go to the Quantum Health member portal.

Visit the Benefits & Worklife webpage for FAQ and updates as the July 1 transition approaches.