Teachers' insurance plan cuts costs, convenience

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Kayla Bunge
Thursday, November 29, 2007

Chris Raddatz won’t have the convenience of 24-hour or drive-through pharmacy service after today.

“I’m disappointed,” said the third-grade teacher at Townview Elementary School in the Beloit Turner School District. “It was very convenient to call it in and punch in a time to pick it up. It worked really well after a long day of work just to drive through and pick it up.

“I won’t have that luxury anymore.”

Raddatz and other teachers who carry insurance from WEA Trust no longer will be able to fill their prescriptions at Walgreens. Locally, that includes teachers in the Beloit Turner, Delavan-Darien and Elkhorn school districts.

The problem stems from a disagreement between Walgreens and the insurance company’s pharmacy benefit manager, CVS Caremark, over reimbursement rates.

“Caremark’s reimbursements are so far below market that we can’t stay in the plan at that rate,” Walgreens spokesman Michael Polzin said. “To leave a benefit plan is an extraordinary step for us, but it shows how extraordinarily low the rates are.”

But CVS Caremark’s rates are competitive, spokeswoman Carolyn Castel said.

“In fact, the reimbursement Caremark pays to Walgreens is no different than the reimbursement for other large chain retail pharmacies in the network,” she wrote in an e-mail. “Therefore, Caremark has struggled with understanding what motivated Walgreens to suddenly remove themselves from the pharmacy network.”

Castel said no other pharmacy has left CVS Caremark’s pharmacy network because it felt it was not being paid enough for prescriptions.

Walgreens has notified CVS Caremark that it will withdraw as a provider effective Friday, unless an agreement is reached. That means teachers insured by WEA Trust will have to go elsewhere to fill their prescriptions.

Polzin said withdrawing as a pharmacy provider is drastic and will mean less business for local Walgreens stores. But he said the move is a reflection of the “extraordinary situation.”

WEA Trust spokesman Amir Zaman said the insurance company wants Walgreens in the network.

“That’s our highest priority,” he said, “and we’ve impressed upon Caremark on numerous occasions over the past few weeks—almost on a daily basis—that we need to be working to get Walgreens back in the network.”

Zaman said CVS Caremark has made at least two offers to Walgreens on WEA Trust’s behalf, and Walgreens hasn’t responded.

But just because Walgreens “turns off the switch” Friday, Zaman said, doesn’t mean it’s the last the company will hear from WEA Trust.

“What we are telling Caremark is we purchased a pharmacy network that includes Walgreens, and we want you to give us a network that includes Walgreens,” he said.

Last updated: 9:38 pm Thursday, December 13, 2012

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