Pharmacy We connect
simplicity and
better care.

Health doesn’t happen in silos. Medical and pharmacy coverage shouldn’t either. Powered by our medical and pharmacy claims data, our programs work together to better identify care gaps, recommend alternative drug options and proactively reach out to members and their doctors for improved health outcomes. And with connected coverage you get the ease of one contract, one invoice and one contact for questions. And your employees get one ID card, one website and one contact phone number.

Pharmacy Coverage

Combining medical and pharmacy can mean better outcomes and big savings.


When choosing pharmacy benefits, what should you focus on?

Having both medical and pharmacy benefits with Anthem enables us to better identify gaps in your employees’ health care. We contact members and their doctors when we see members aren’t refilling their medications. We also identify members who may benefit from a drug they don’t currently use.

Closing care gaps leads to better care and better health.
  • We identify 28% more care gaps
  • Close 26% more gaps within 12 months¹, ²
Improved coordination improves health outcomes.

Our pharmacy benefit works seamlessly with your medical benefits to deliver better patient results.

Personal support. Increased medication adherence.

Specialty pharmacy programs improve medication adherence.³ Nurses and pharmacists provide caring support and help for members.

Targeted communication. Meaningful results.

Personal Medication Review mailings spotlight member actions needed for medication safety, cost savings, and adherence.

¹ Integrated medical and pharmacy claims data vs. pharmacy data from a carve-out pharmacy benefit manager. Source: Outcomes for MyHealth Advantage using our pharmacy data when compared to carve-out pharmacy data. Results are for our enterprise commercial business; data for the 12-month period ended September 30, 2013.

² Results shown do not represent a guarantee of coverage or outcomes, and may not be representative for your group. Group-specific results/outcomes/cost savings will vary.

³ When compared to local retail pharmacies

We have pharmacy choices to match your goals. Want lots of local in-network pharmacies or the most drug list choices for employees? Done. Want to maximize savings? We’ve got that, too.

Over 69,000 retail pharmacies

nationwide in our National Plus Network.

More options. More savings.
  • Our Rx Choice Tiered Network offers up to $3 PMPM savings. This retail network has ~20,000 locations, plus the option to use more pharmacies in the National Plus Network.*
  • Our retail 90 programs allow members to fill a 90-day supply of medication at a participating local pharmacy. Plus members get the convenience of only one pharmacy trip every three months.
Drug lists to meet your needs.

We manage our drug lists to combine clinical quality and cost effectiveness. Our broader drug list covers 99% of drugs with select closed drug classes and provides enhanced rebate opportunities. Our focused drug list excludes medications that cost more, so it’s easier to find the most cost-effective choices, including OTC and lower-cost alternatives.

* Your employees have more pharmacy location choices when they pay a small additional fee.

Seamless and simplified, that’s the benefit of coordinated medical and pharmacy coverage.

Better for your business
  • A single account management team
  • One group application
  • One eligibility feed
  • One bill
Better for your employees
  • One enrollment application
  • One ID card
  • One website for all health care needs
  • One mobile app for medical & pharmacy
    (including mobile ID card)

Big savings. Big results. By combining our medical and pharmacy programs, employers could save up to $28 PMPM in medical and pharmacy costs.¹

Our programs work together and lead to:

Fewer hospital stays

Fewer ER visits

Lower medical costs

¹ 2014 internal analysis; savings correlation associated with members who have chronic conditions and are engaged in their health care and our programs. Results shown do not represent a guarantee of coverage or outcomes, and may not be representative for your group. Group-specific results/outcomes/cost savings will vary.

Anthem Pharmacy + Medical

Combine our programs to save money and improve health outcomes

Explore new insights
on integrated & specialty pharmacy benefits

Our latest research shows how employers can help manage costs and keep their employees healthy.

Sharon’s Story: medical + pharmacy in action

After multiple ER visits and hospital stays, a case manager is assigned to work with Sharon to help her improve her health. The case manager sees a care gap alert that shows Sharon is late in filling her Hepatitis C medication. Sharon's doctor is also alerted.
The case manager and the doctor help Sharon understand it’s necessary to take her Hepatitis C medication daily and complete all therapy to cure Hepatitis C. Sharon and her case manager create daily medication reminders so that Sharon successfully completes her treatment.
12 weeks later, Sharon sees her tests. She is happy to know she is now free of the Hepatitis C virus.
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Better for you.
Better for your employees.

With medical and pharmacy benefits from Anthem, your business will have seamless administration, streamlined enrollment and simplified claims. Your employees will enjoy more complete care that helps them stay healthy and on the job.

Ready to take the next step?