CalCPA Health partners with leading pharmacy benefit managers to provide members with broad access, competitive pricing, and convenient prescription services. Your pharmacy administrator depends on your medical plan:

• PPO & HSA Plans → Express Scripts (ESI)
• HMO Plans → CarelonRx

PPO & HSA Memers

If you are enrolled in a CalCPA Health PPO or HSA plan, your prescription coverage is administered through Express Scripts (ESI).

What You Can Expect

• Access to a large national retail pharmacy network
• 90-day supplies for maintenance medications
• Convenient home delivery options
• Specialty pharmacy support and clinical oversight

Additional Savings Opportunities

CalCPA Health PPO and HSA medical plan enrollees now benefit from built-in GoodRx prescription pricing (when available) as part of their pharmacy coverage through Express Scripts Rx.

When your prescription is processed, the system compares your plan pricing with the available GoodRx-discounted price. If the GoodRx price is lower than your plan’s already-negotiated cost, you pay the lower amount automatically. There’s no separate enrollment, no discount card to present, and no need to price-shop.

Unlike stand-alone discount programs, prescriptions processed through this partnership apply toward your deductible and out-of-pocket maximum. This program ensures you receive competitive pricing while maintaining the protections and accumulators of your CalCPA Health pharmacy benefit.

Reminder: Mail Order Savings

For many maintenance medications, the Express Scripts mail-order pharmacy offers lower copays and overall drug costs. Be sure to compare your options for additional savings.

Questions about your pharmacy coverage?

• Log in to your Express Scripts member portal
• Or contact Banyan Administrators, Managers of the CalCPA Health program, for assistance.

HMO Members

If you are enrolled in a CalCPA Health HMO plan, your pharmacy benefit is administered by CarelonRx.

CarelonRx works in coordination with your Anthem HMO coverage to provide:

• Access to a broad retail pharmacy network
• Mail-order delivery for maintenance medications
• Specialty medication management
• Integrated medical and pharmacy support

Questions about your pharmacy coverage?

• Log in to Anthem’s member portal if you have CarelonRx for your pharmacy benefit
• Or contact Banyan Administrators, Managers of the CalCPA Health program, for assistance.