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About Us
Welcome to CarolinaCARE, the mail-order pharmacy for teammates in the Southeast who have selected the service for maintenance prescriptions.
CarolinaCARE is a convenient home-delivery pharmacy service available to Atrium Health teammates and their dependents who are enrolled in an eligible Atrium Health medical plan. This prescription service is offered to individuals taking medications for chronic conditions (maintenance medications), such as diabetes or high blood pressure, as well as other routine medications, like birth control or inhalers for asthma.
1-866-697-6800
Monday through Friday,
8 a.m. to 5 p.m.
Airport Center: 4400 Golf Acres Dr., Bldg J, Suite C, Charlotte, NC
Teammates and their dependents ordering Specialty Pharmacy medications from CarolinaCARE need to manage their prescriptions over the phone, one of two ways:
If you have a chronic condition, such as diabetes, high blood pressure or high cholesterol, and are interested in lowering your medication costs, One-on-One Rx may be right for you.
One-on-One Rx is an appointment-based medication therapy management service that lets members speak directly with a pharmacist, on the phone, or virtually (using a PC, tablet or mobile phone) to reduce medication costs.
By talking with you and working with your physician, our pharmacists can help find the best way to lower your medication costs. This is a FREE service offered by CarolinaCARE.
For more information and to schedule an appointment, visit your region’s One-on-One Rx page, or Schedule Your Appointment.
Prescription Price Estimator Tool
Atrium Health Contraceptives List
Specialty Medication Formulary
Optum DAW Prior Authorization Form
Drug Reimbursement Form (paper copy)
Drug Reimbursement Form (electronic)
CarolinaCARE Consent for Adolescent Patients
It is a good idea to start by creating a MyAtriumHealth account if you don't already have one. When appropriate, ask your physician for two prescriptions: a 30-day supply to be filled at your retail pharmacy and a 90-day prescription to submit immediately to CarolinaCARE, your mail service facility. Prescriptions are mailed to your home or post office box and require payment in advance of shipping. Please make sure that you indicate a payment option each time an order is submitted to CarolinaCARE. All payment information is both secure and confidential.
Orders for mail service may be submitted in the following ways:
CarolinaCARE representatives are available 8AM to 5PM, Monday through Friday, to answer any questions you may have about the mail program 866-697-6800.
The prescription automatic refill program is a service offered by CarolinaCARE. It is designed to help you save valuable time with minimal effort to get the prescriptions you need. Most maintenance medications taken on a regularly scheduled basis can be enrolled in the automatic refill program. By using the automatic refill tool, CarolinaCARE will
NOTE - The following are not eligible for enrollment in the automatic refill program: prescriptions designated as specialty medications, as controlled substances (Schedule II, III, IV, V), and medications that are covered by Medicaid.
For all prescriptions you've selected to enroll in the prescription automatic refill program, you will receive messages through the MyAtriumHealth portal.
There is no cost to enroll your selected medications for automatic refill and shipping. This is a FREE service offered by CarolinaCARE exclusively for your convenience.
Enrollment in this program provides:
To enroll in the automatic refill program:
Your request will be sent to the CarolinaCARE team. The process may take up to 72 hours to complete your enrollment. NOTE: Not all prescriptions are eligible for this program. Be sure to set up your payment method in the Manage Payments section.
No, there are a few exceptions regarding which medications can be selected for automatic shipping. Specialty medications, controlled substances (Schedule II, III, IV, and V) and any medications covered by Medicare and Medicaid are NOT eligible for the automatic refill program.
Approximately 7-10 days before your prescriptions are scheduled for shipping, you will receive a reminder message through the MyAtriumHealth portal about each authorized medication.
Any change to a prescheduled order (example, a change in shipping address, payment method, quantity shipped, request for cancellation,etc) will need to be communicated to a CarolinaCARE representative before the order is in process for shipping. You can check the order status at any time, 24/7, by checking your prescription list on the MyAtriumHealth portal.
Prescriptions can be removed from the automatic refill program before the next fill is due.
Your request will be sent to the CarolinaCARE team. The process to remove the selected drug(s) from automatic refills may take up to 72 hours to complete.
You may contact CarolinaCARE by sending a message through the MyAtriumHealth portal. Or, you can call CarolinaCARE by telephone, Monday - Friday, 8AM - 5PM at 1-866-697-6800.
No. For your safety and the safety of others, regulatory guidelines prohibit the return of medications to the Pharmacy once they leave the facility.
Enrollment in an automatic refill program depends on your plan type. The guidelines issued through the Centers for Medicare and Medicaid (CMS) are:
If you or your dependent(s) have prescription coverage through CMS, please consult with a CarolinaCARE team member to determine eligiblity for enrollment in the Automatic Refill Program, Mon-Fri, 8AM-5PM at 1-866-697-6800.
Before you fill any prescription, now or in the future, be sure to search the Atrium Health Prescription Formulary for your medication to confirm that it is covered by the Health Plan.
If you need to fill a prescription during the first 31 days of employment, before your coverage is active, it's important to remember the following:
No. Reimbursement of pre-coverage prescription expenses through Optum Rx is time-sensitive! After election of coverage and BEFORE THE NEXT FILL OF THE SAME PRESCRIPTION is due, complete and submit the Optum Rx Prescription Reimbursement Form directly to Optum Rx. The form is available on the Atrium Health Teammate site. The form can be submitted to Optum Rx in two ways:
Specialty medications follow a different process for both filling the specialty drug and for reimbursement of the prescription expense. If you or your dependent use a specialty medication, contact a representative of Atrium Health Specialty Pharmacy Service before you run out of medication at 1-888-835-0063.
Yes, prescriptions that require compounding by a pharmacy are covered under the prescription benefit when each of the following conditions are met:
CarolinaCARE, your prescription mail service pharmacy, does not process compounded prescriptions. However, many of the commonly prescribed "simple" compounds can be mixed and dispensed at most local retail pharmacies.
OptumRx, the pharmacy benefits partner of CarolinaCARE, has created a user guide to assist you with the selection of a pharmacy which has been credentialed through the OptumRx Network Compound Credentialing Program (NCCP). This means the pharmacy has taken additional steps to complete a rigorous set of requirements that ensures a safe environment to produce a high-quality product. In general, there are seven(7) categories of compounds that may require use of a credentialed compounding pharmacy. The chart on each page of the OptumRx user guide will let you know which pharmacy may be able to compound the medication you need. For example, if the prescription appears to be for topical use, look for the TOP symbol listed next to the pharmacy authorized to ship to your state.
Generally, a controlled substance refers to a medication where the manufacture, possession, and use are restricted by law. As defined by the National Cancer Institute, these drugs are '... tightly controlled because they may be abused or cause addiction.' The control applies to the way a substance is made, used, handled, stored, and distributed. Controlled substances include opioids, stimulants, depressants, hallucinogens, and anabolic steroids. Controlled substances which have no known medical use are illegal in the United States. The Controlled Substance Act places these drugs into one of five schedules, depending on the product's medical use, potential for abuse (high, medium or low), and safety or dependence liability. Scheduled placement may vary by state. Examples include:
Opioids, as defined by the National Institute of Health (NIH), are a class of drugs that include heroin (an illegal drug), the synthetic opioids such as fentanyl, and pain relievers such as oxycodone (Oxycontin), hydrocodone (Vicodin), codeine, and morphine which are available legally by prescription, and many others.
Yes. Controlled substances can only be mailed (ex, USPS) or shipped (ex, FedEx) by individuals with the proper medical licensing and who are registered with the DEA , like pharmacists and medical providers. To meet federal and state pharmacy regulatory guidelines, a signature by an individual who is age 18 years or older is required at the time of delivery of controlled substances that are shipped to you and at the time of pick-up from a retail pharmacy. There may also be limits placed on the amount of the controlled substance that can be prescribed and shipped. Your pharmacist is aware of these limitations by law and will contact your provider whenever the quantity prescribed is different from the amount allowed by federal and state laws.
ACT NOW. To track delivery of your packages shipped by CarolinaCARE, sign-up for the FREE tracking service at USPS.com and FedEx.com.
CarolinaCARE will only ship controlled substances to North Carolina, South Carolina and Georgia.
Ask your pharmacist to provide two (2) labeled prescription vials or bottles with your order. You can then divide the medication in the right amount to send to school, daycare, etc, and to keep a supply at home if needed.
Additional Information: All controlled substances can be filled monthly at your participating community retail pharmacy in a 30-day supply only. A signature is required at the time of pick-up from your local retail pharmacy. Copays and co-insurance may be higher for retail pick-up.
You and other members of your household may be covered by more than one health insurance plan. Coordination of benefits (COB) is a process where insurance companies work together to manage all your benefits when you have dual coverage. COB now includes both medical and prescription claims processed through CarolinaCARE and retail pharmacies. The insurance coverage identified as primary will apply its payment first, based on the benefit plan design. Then, the second insurance plan will apply its payment. If there is an outstanding balance after both insurance plans have paid their portion of the bill, you may be responsible for the remaining balance.
For additional information about coordination of benefits, contact the medical plan provider for your Atrium Health plan, MedCost Benefit Services, at 1-800-795-1023 or Cigna at 1- 800-244-6224.
CarolinaCARE is the prescription home delivery pharmacy owned and operated by Atrium Health. You will save both time and money by using CarolinaCARE as soon as possible for new prescriptions and refills of maintenance medications (i.e., those medications taken for on-going, chronic medical conditions).
Yes. There is a network of retail pharmacies owned and operated by Atrium Health. Locations are in the Charlotte-metro area:
CarolinaCARE partners with Optum Rx, a nationwide Pharmacy Benefits Manager (PBM), to administer your prescription benefit in the most cost-effective manner. Together, CarolinaCARE and Optum Rx work with pharmacists to handle all the details of your prescription claims and to manage the drug formulary for the Atrium Health pharmacy benefit plans.
It is a good idea to start by creating a MyAtriumHealth account if you don't already have one. When appropriate, ask your physician for two prescriptions - a 30-day supply to be filled at your retail pharmacy and a 90-day prescription to submit immediately to CarolinaCARE, your mail service facility. Prescriptions are mailed to your home or post office box and require payment in advance of shipping. Please make sure that you indicate a payment option each time an order is submitted to CarolinaCARE. All payment information is both secure and confidential.
Orders for mail service may be submitted in the following ways:
CarolinaCARE representatives are available 8AM to 5PM, Monday through Friday, to answer any questions you may have about the mail program 1-866-697-6800.
All correspondence for CarolinaCARE should be addressed to: CarolinaCARE, P.O. Box 31691, Charlotte, NC 28231-1691.
Not necessarily. Prescription ID cards are sent after your initial enrollment into the medical plan, and to new teammates as they choose to participate in the medical plan benefit. You may request a replacement ID card at any time by contacting:
There are a number of advantages for using CarolinaCARE and/or Atrium Health retail pharmacies as your pharmacy of choice:
Both CarolinaCARE and Atrium Health retail pharmacies have a preferred copay structure for medications and supplies on the Atrium Health Preventive Drug List. For these select medications and supplies, you may pay a reduced copay/coinsurance for a 30 day supply at CarolinaCARE and Atrium Health retail pharmacies.Yes, there is an advantage to use CarolinaCARE for a 90 day supply for maintenance medications. You will have a lower copay for products on the Atrium Health Preventive Drug List at all times, as well as all other maintenance medications once you have met your deductible. The following link provides you with a comparison of copay and co-insurance levels both before and after the deductible. Click on the appropriate link to the Atrium Health Plan documents for your work location.
To print a temporary prescription card, log on to the member portal for the medical plan provider of your insurance (i.e., MedCost or Cigna).
To resolve any issues regarding ID cards or the need for replacement cards, contact your medical plan provider - MedCost Benefit Services at 1-800-795-1023 or Cigna at 1-800-244-6224.
The clinical teams for CarolinaCARE and Optum Rx work closely with your HR-Benefits Team to design a comprehensive formulary of medications. The Teams meet regularly to review both new drugs and existing drugs. Medications are selected based on effectiveness, safety, tolerability, and cost.
Many medications are approved to treat specific conditions only. The prior authorization is used as a safety measure. It is a process to verify with your doctor that you have been diagnosed with the condition that the drug is intended to treat. Our benefits partner, Optum Rx, will work with you and your doctor to obtain the preauthorization as quickly as possible following the clinical guidelines.
This is a safety measure. Many drugs are approved for only a limited duration of therapy. There may be maximum doses per day or week that should not be exceeded; or, the medication may require a dose adjustment based on specific criteria. The guidelines are established for drugs with these warnings. The limited supply is to protect you.
E-prescribing (electronic submission) by yourmedical provider is the easiest, most efficient way to send prescriptions directly to CarolinaCARE. The NCPDP number is 3400152, and will help your doctor quickly locate our pharmacy in the e-prescribing database. Secondly, you can complete a prescription order form and mail the prescription paper copy along with payment and the completed form to CarolinaCARE. Please allow extra time for mail delivery of your prescriptions to reach CarolinaCARE.
E-prescribed orders (electronically submitted from the physician's office) will be filled, charged and shipped as soon as they are received by CarolinaCARE. Please make sure your address and method of payment are up-to-date in the MyAtriumHealth portal. CarolinaCARE will ship your order within 3-5 business days after it is received. For patient safety and in accordance with guidelines provided by the North Carolina Board of Pharmacy, medications will not be accepted for return once they have shipped from the CarolinaCARE facility.
No. However, if your provider is an Atrium Health provider, CarolinaCARE can request a new prescription on your behalf. For providers outside of Atrium Health, please contact them directly and ask them to send a NEW prescription order directly to CarolinaCARE.
Yes. Before you can charge prescriptions to your FSA or HSA card, you must activate the card and add the card information in the Manage Payment section of the MyAtriumHealth portal.
Most medications are covered by your prescription benefit at varying cost share and copay levels. The specific listof drugs and supplies, known as the prescription formulary, is updated monthly and appears on the Atrium Health Teammate site. For a price estimate, go to the prescription price estimator tool. The link takes you to the Optum Rx website where you can get an estimated price for medications and supplies, both before and after the deductible for the HSA plan.
Beginning November 1, 2023, children ages 13-17 will need to create a new account on the CarolinaCARE website in order to see or order their prescription medications. Parents will no longer be able to view or manage their child's prescriptions. If you have a child who will turn 13 after this date, this change will automatically take place on their 13th birthday.
Up to age 13, parents/legal guardians can fully access all of their child's prescription information. On the child's 13th birthday, parental access is automatically blocked and parents will no longer see their child's prescriptions.
Under North Carolina law, health systems and other providers must keep certain types of health information and services given to minors private. This information can only be shared with the minor patient’s permission. If you are the parent/legal guardian with CarolinaCARE insurance, and your child is between 13 and 17 years old and you want to see all their prescribed and dispensed medicines via MyAtriumHealth, you and your teenage patient must fill out and sign a Consent for Full Access Form. Each parent or guardian needs their own consent form. Your child can change their mind and stop you from having full access to their complete medicine record via MyAtriumHealth at any time.
At age 13, teens can get their own MyAtriumHealth.org account with verbal consent from a parent/legal guardian at their next in-person visit with their provider. Parental access to the teen's MyAtriumHealth account automatically becomes limited. To get ready for this transition, you or your child can ask your teen's provider at their next office visit about setting up a MyAtriumHealth account. This needs to be done in person. Your child will need verbal permission from a parent or legal guardian and an order from their provider to get their own account. Your child will receive a text or an email to activate their account once the request is submitted by their provider. Your child must have their own email address or phone number to complete this step.
No. In order to protect your child's privacy and follow state laws, you will not be able to view, access or manage your child's prescriptions after they turn 13 years old without a signed Consent for Full Access Form. As always, a parent or guardian may call the doctor's office to discuss any concerns about their child's health.
There are several ways parents can help a child ages 13-17 to refill a prescription medication. If you have access to your child's prescription medication label, contact CarolinaCARE at 866-697-6800 or 704-512-6800 to refill a prescription over the phone. If your child receives a new prescription medication from an Atrium Health provider, they will be asked which pharmacy to send it to. They should choose CarolinaCARE. Contact CarolinaCARE at 866-697-6800 or 704-512-6800 with any questions you or your child have about this transition or creating a new account.
After logging in to your MyAtrium Health account, request Family Access from the menu and follow the prompts. It may take up to 3 business days to finalize your access.
NOTE: HIPAA regulations require dependents 18 years of age and older (including a spouse) to create and manage their own MyAtriumHealth account.
