We are expanding the IngenioRx, soon-to-be CarelonRx, Specialty Drug Cost Relief program, effective January 1, 2023. The program, currently available to Administrative Services Only (ASO) plans, is being expanded to be compatible with health savings account (HSA) plans, as well as fully insured plans in select states.
Starting in late November, we’ll send eligible members letters before their effective date encouraging them to enroll in the program.
Fully Insured Expansion
Pending Department of Insurance (DOI) approvals, the program will be embedded into fully insured plans in select states beginning January 1, 2023. Members of Small Group, Large Group, and National plans will have low or no copays for most of their specialty medicines (HSA requirements will apply).
The program will be available at no additional cost to fully insured and Anthem Balance Funding clients in:
- Indiana
- Missouri*
- New Hampshire**
- Nevada
- Ohio***
- Wisconsin
- Colorado** (Large Group and National Accounts only)
HSA Enhancements
We’ve made the program compatible with HSA plans for both fully insured (in approved states) and ASO business, effective January 1, 2023. Members will pay a share of the costs for specialty medicines until they reach their deductible. Once the deductible is met, they will pay $0 for specialty medicines.
The program also helps Large Group and National ASO clients save up to 25% of their total pharmacy drug costs.
Member Communications
We will contact members of fully insured and eligible ASO plans with letters, phone calls, and emails to enroll them in the program.
Please contact your plan representative for more information.
* DOI approval pending for Small Group ACA
** DOI approval pending for Large Group
*** DOI approval pending for Large Group and Small Group ACA, Southern Ohio Chamber Alliance & Ohio Farm Bureau