CarolinaCARE is the prescription service and specialty medication pharmacy for the Atrium Health Navicent Plans. Health Plan members access CarolinaCARE for Affordable Care Act (ACA) medications, preventive medications, maintenance and specialty medications.
Retail Pharmacy is any pharmacy outside of CarolinaCARE which can be used for filling one-time prescriptions.
It is recommended you evaluate your current medications and possible need for future medications and review the formulary to determine cost/tier at CarolinaCareRx.org > Health Plan Prescription Price Estimator. If you have a chronic medical condition or take at least one medication on a daily basis, you can make an appointment and review your medication history with a pharmacist at One-on-One Rx. Visit CarolinaCareRx.
CarolinaCARE now offers two convenient prescription refill programs. You can sign-up to enroll in either one:
To enroll, please log in to the CarolinaCARE website, read and accept the Terms and Conditions for your preferred refill program.
Please do not select Specialty medication for automatic refills if your specialty drug is managed by Atrium Health Specialty Pharmacy Services. The specialty team will continue to contact you each month about refills for these specific medications.
Learn more about CarolinaCARE’s services, the prescription benefit and factors to consider when enrolling in a health plan as it pertains to prescription coverage. Access the following episodes:
Effective January 1, 2024, payroll deduction will no longer be a payment option for prescriptions filled through the CarolinaCARE mail delivery program.
Here is what you need to know in order to be ready for the change on January 1, 2024.
Why is payroll deduction going away?
CarolinaCARE is growing and implementing best in class software to serve teammates and health plan members most effectively. In 2024, the new platform will no longer have a payroll deduction option.
What other options can I use to pay for my prescription orders at CarolinaCARE?
As of January 1, 2024, you can pay for prescription orders using your Health Savings Account (HSA) card, Flexible Spending Account (FSA) card, credit and debit cards such as Visa, Mastercard, American Express and Discover.
Is there an advantage to using my HSA or FSA card instead of a regular credit or debit card?
Yes. Teammates can use their HSA or FSA cards for a tax-free way to pay for prescriptions and other qualified medical expenses.
I currently use payroll deduction as a back-up to my HSA or FSA card whenever all my funds are spent. What will happen when payroll deduction goes away?
Again, when payroll deduction is no longer available as of January 1, 2024, you will be able to use your HSA or FSA account cards, credit and debit cards to pay for prescription orders.
What steps can I take to plan for paying for prescriptions?
It is important to review the cost of all medications and medical supplies that you and your family currently use. Try to anticipate any other prescription needs you may have in 2024 (to include over-the-counter medications like vitamins, cough and cold products, and allergy relief). The CarolinaCARE prescription price estimator may be a helpful tool to guide you in adding up the expenses. This way, you can make a better estimate of the amount that you will need to contribute to your HSA or FSA account to cover costs for the entire year.
You may want to make an online appointment and speak with a pharmacist at One-on-One Rx about your medicine costs. Visit www.CarolinaCARERx.org for more information about how to schedule an appointment.
TO ACTIVE EMPLOYEES OR COBRA PARTICIPANTS ELIGIBLE FOR MEDICAL COVERAGE AS OF JANUARY 1, 2023
If you are Medicare eligible (or if you or your dependents are Medicare eligible or will be in the near future) — and you participate in Atrium Health Navicent (the “Company”) medical coverage — this notice applies to you. Since we may not know if your dependents are Medicare eligible, we are sending this notice to all employees and COBRA participants who are eligible for Atrium Health Navicent's medical coverage.
In this letter and in the notice that follows, Atrium Health Navicent's medical coverage also are referred to as “Company-sponsored coverage.” Please disregard this information if it does not apply to you.
The mail service pharmacy reduces your out-of-pocket expenses and the time you spend ordering and picking up prescriptions by allowing you to receive up to a 90-day supply of your medication. All prescription mail delivery services are administered by CarolinaCARE.Creditable Coverage Notice Please read this notice carefully and keep it where you can find it. The notice has information about your current prescription drug coverage with Atrium Health Navicent and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area.
WHEN CAN YOU JOIN A MEDICARE DRUG PLAN?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 through December 7. However, if you lose your current creditable prescription drug coverage through no fault of your own, you also will be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
WHAT HAPPENS TO YOUR CURRENT COVERAGE IF YOU DECIDE TO JOIN A MEDICARE DRUG PLAN?
If you decide to join a Medicare drug plan, your current Atrium Health Navicent coverage will not be affected. Your current Company-sponsored coverage pays for other health expenses, in addition to prescription drugs, and you will still be eligible to receive all of your current health and prescription drug benefits if you choose to enroll in a Medicare prescription drug plan. However, if you drop your Company-sponsored coverage, be aware that you and your dependents may not be able to get this coverage back.
WHEN WILL YOU PAY A HIGHER PREMIUM (PENALTY) TO JOIN A MEDICARE DRUG PLAN?
You should also know that if you drop or lose your current coverage with Atrium Health Navicent and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
FOR MORE INFORMATION ABOUT THIS NOTICE OR YOUR CURRENT PRESCRIPTION DRUG COVERAGE ...
Contact Atrium Health Navicent's Benefits Service Center at 1-800-964-4780 for information about your company sponsored coverage. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if the coverage through Atrium Health Navicent changes. You also may request a copy of this notice at any time.
FOR MORE INFORMATION ABOUT YOUR OPTIONS UNDER MEDICARE PRESCRIPTION DRUG COVERAGE...
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:
Discrimination is Against the Law
Atrium Health Navicent complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, gender identity, sexual orientation, pregnancy, or genetic information.
Atrium Health Navicent: