New Member ID Cards
Beginning in October 2023, members will receive a new Member ID card in the mail. This includes members from each of the following plans:
- Sunshine Health Medicaid (MMA)
- Long Term Care (LTC)
- Serious Mental Illness (SMI) Specialty Plan
- Child Welfare Specialty Plan (CWSP)
- Children's Medical Services (CMS) Health Plan
The new ID card will be effective January 1, 2024. We are sending members a new card for 2024 because we updated the pharmacy information on the front of the card, including the Pharmacy Benefit Manager (PBM). The PBM is changing to Express Scripts.
What You Should Do Now
- Keep using your current ID card until December 31, 2023.
- Do not use the new card yet. It will not work before January 1, 2024.
What You Should Do on January 1, 2024:
- Start using the new card on January 1, 2024. You will need the new card to get prescription drugs.
- Destroy the old ID card. It will stop working as of January 1, 2024.
- Make sure your pharmacy is still in our network. You can check this on our website at FindAProvider.SunshineHealth.com. Or you can call Member Services at the number on the back of the ID card.
Please keep your ID card with you at all times.
Express Scripts Transition: Frequently Asked Questions
This FAQ provides additional information on the migration of our Pharmacy Benefit Manager (PBM) services from CVS® to Express Scripts®, effective January 1, 2024.
Express Scripts is a pharmacy benefit management (PBM) company serving more than 100 million Americans. Express Scripts Pharmacy delivers specialized care that puts patients first through a smarter approach to pharmacy services.
Express Scripts as our PBM will bring increased levels of transparency and value, positioning us to provide the highest level of quality at the lowest possible cost to our members.
Express Scripts will be the PBM of record providing pharmacy claims adjudication, pharmacy network administration and rebate administration on behalf of our health plan.
There will be no immediate change in service for our members, although they will receive new ID cards. We will continue to provide the same member-focused care and support as we do today.
Our highest priority continues to be serving all our members, and we remain committed to providing affordable quality healthcare services. Our team is working closely with both CVS and Express Scripts to ensure a seamless migration.
Yes, Amazon is part of the Express Scripts network.
No, CVS Caremark Mail Service Pharmacy will be out of network, effective January 1, 2024. If members wish to continue using mail order in 2024, they must switch to Express Scripts Pharmacy.
Members have a choice to use other pharmacies that offer home delivery, but Express Scripts Pharmacy is the preferred mail order pharmacy for our health plan.
Yes. Impacted Medicaid members will receive a Mail Order Change notification letter.
For existing mail order users:
- Most open prescription refills will be automatically transferred to Express Scripts
- Refills for controlled drugs, such as Alprazolam, Clonazepam, Pregabalin, Tramadol, Zolpidem, etc., will not automatically transfer to Express Scripts Pharmacy; members must request a new prescription from their provider
For new mail order prescriptions on or after January 1, 2024, members may do one of the following:
- Ask their provider to electronically submit or fax a new prescription to Express Scripts Pharmacy, as listed on their medical ID cards
- Visit Express Scripts Pharmacy to register or sign in, then follow the guided steps to request a prescription
- Call Express Scripts Pharmacy, who will contact their provider for a new prescription to be filled via mail order
- Mail a Home Delivery Order Form directly to Express Scripts Pharmacy
Yes, members will be able to download the Express Scripts Pharmacy app, available on the App Store and Google Play. Members with a mail order benefit can order medications, track delivery and more.