Anthem Blue Cross reversal is victory for HIV/AIDS patients

In Advocacy, News by AHF

We are pleased to report that insurance company Anthem Blue Cross has reversed its controversial decision to force HIV/AIDS patients into mandatory mail-order pharmacy use.

Under pressure from health care organizations and patient advocacy groups—including AIDS Healthcare Foundation—and a lawsuit spearheaded by Consumer Watchdog, Anthem has restructured the program so it is no longer mandatory.  Patients will have the ability to easily opt out from the program and stay with their pharmacy.

“This is a key victory in the fight for patient’s rights,” said Michael Weinstein, President of AIDS Healthcare Foundation. “It is important for HIV/AIDS patients to feel comfortable with their providers and to have the choice of which pharmacy they would like to work with.  We are pleased that patients with Anthem Blue Cross will be able to continue to fill their medications at the retail pharmacy of their choice.”

Anthem has agreed to implement its mail order program with a broad opt out policy.  That policy permits patients to opt out for any reason.  This means that affected patients need only call a dedicated 1-800 number and request to be opted out.  This program is effective June 1, 2013.

If you are an Anthem Blue Cross customer, you can continue to fill your medications at the pharmacy of your choice simply by making one brief phone call to Anthem to say “I OPT OUT!”

You will receive a notice in the mail from Anthem stating that you can either transition your medication to mail order or opt out of using the mail order.

Opt out process:

  • Call Anthem at (888) 310-4043, Monday – Friday, 5 a.m. – 7 p.m. Pacific Time
  • Your call will be received by a live customer service representative dedicated to handling your opt-out request
  • Tell the customer representative that YOU WANT TO OPT OUT and continue receiving medication through your local retail pharmacy
  • You do not have to give any reason for why you want to opt out, and there are no requirements for you to opt out.
  • The customer representative will provide you with a confirmation number, and mail confirmation of your opt-out to the address on file
  • You can then immediately fill your medication at your local pharmacy

You must opt-out before August 1, 2013 or you will automatically be enrolled in the mail order program. However, should you miss the August 1 cut-off you can still fill 2 month’s worth of medication at your retail pharmacy, or simply call Anthem at the above number anytime and opt-out of the program.

Once you opt out you are opted out for the life of your Anthem coverage; you never have to call Anthem about opting out again and you can continue to fill your HIV/AIDs medication at the pharmacy of your choice.

Opting out does not affect your insurance coverage, now or in the future; nor does it affect any special eligibility or financial statuses currently in place with Anthem.

For questions please contact the Law Offices of David Balto, (202) 789-5424.

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