Preguntas frecuentes (FAQs)

 

¿Qué es un administrador de beneficios de farmacia (PBM)?

A pharmacy benefits manager manages members’ prescriptions and pharmacy needs.

ASCENDpbm is an industry-leading pharmacy benefit manager focusing on our patients, their experiences, and outcomes. Members have experienced cost savings and excellent customer service. By switching, the plan sponsor (or employer) will gain efficiencies by having ASCENDpbm as their primary PBM.

¿Por qué está cambiando el PBM y cómo me impactará?

Typically employers assess PBM performance annually.  Member services, cost savings, and customer service are key factors in their assessment.

Your employer has selected ASCENDpbm, an industry-leading pharmacy benefit manager, with a focus on you as the patient, your experience, and your outcomes.  ASCENDpbm offers unique programs to generate savings for employees and their family members and is recognized for its commitment to excellent customer service.

Los miembros deben experimentar pocos cambios, más allá de una tarjeta de seguro actualizada, en la transición a ASCENDpbm. Algunos pueden ser notificados o contactados para informarles de los programas de ahorro disponibles para reducir el costo de sus recetas.

¿Por qué están cambiando mis beneficios de farmacia?

ASCENDpbm is an industry-leading pharmacy benefit manager (PBM) with a focus on the patient, their experience, and outcomes. Members have experienced cost savings and great customer service. By switching, the plan sponsor (or employer) will gain efficiencies by having ASCENDpbm as their primary PBM.

Además, ASCEND tiene más de 65.000 farmacias en su red, incluidas las farmacias CVS®, Walgreens® y Rite Aid®, de fácil acceso para la mayoría de los miembros en su área de servicio. También hay varios lugares que funcionan las 24 horas del día, de modo que los miembros pueden recoger sus recetas a cualquier hora del día o de la noche. (Puede confirmar si su farmacia tiene una farmacia de 24 horas antes de recogerlas).

¿Por qué es importante que surta mis recetas en una farmacia de la red?

ASCEND has over 65,000+ pharmacies in their network, including CVS®, Walgreens®, and Rite Aid® pharmacies, which are easily accessible for most members in their service area.  To check if your pharmacy is ‘in network’ or to find a network pharmacy near you, use the pharmacy finder tool.

  • Los miembros experimentarán ahorros al usar farmacias "dentro de la red".

  • Los farmacéuticos de las "farmacias de la red" tienen acceso a su seguro de recetas.

  • Su farmacéutico de la red verá si usted es responsable de los costos de las recetas (por ejemplo, su copago, cualquier co-seguro o deducible aplicable).

¿Cuáles son los beneficios de obtener mis medicamentos a través de la venta por correo?

Usando el pedido por correo para los medicamentos de mantenimiento, puedes:

  • Recibir un suministro prolongado de medicamentos

  • Disfrute de una cómoda entrega gratuita en el lugar que elija.

  • Hable con un farmacéutico registrado las 24 horas del día

  • Ordene recargas en línea o por teléfono las 24 horas del día.

Please note: Not all prescription drug benefit plans offer mail-order service. Please check your plan’s Benefits Guide or call the Member Help Desk at (833) 200-5040 to learn if your plan offers mail-order service.

¿Qué es el formulario o la lista de medicamentos preferidos?

ASCEND has a comprehensive list of covered drugs, also referred to as a Formulary or Preferred Drug List. It includes the most commonly covered medications with information about drug tiers and any restrictions or special requirements.

We may add or remove drugs from the formulary during the year. This includes changes to prior authorization requirements, step therapy, quantity limits, and/or moving a drug to a higher cost-sharing tier.

¿Qué se considera una droga especializada?

Specialty Medications are often expensive and prescribed to treat rare or complex diseases like cancer, multiple sclerosis, autoimmune diseases, and rare genetic conditions.  These medications often require special handling and additional services to support patients and are only available from select pharmacies known as Specialty Pharmacies. 

¿Qué debo hacer si tomo un medicamento especializado?

You can call the Member Help Desk at (833) 200-5040 or OptiMed at (877) 232-2857. A care specialist will help you transition your specialty prescription.

¿Seguirá siendo el mismo el costo de mis medicamentos?

Review your plan’s Benefits Guide for up-to-date member costs for prescriptions. Members will be contacted if there are additional savings opportunities available for the medications they have been prescribed.