Pharmacy We connect
simplicity and
better care.

Health doesn’t happen in silos. Medical and pharmacy coverage shouldn’t either. Powered by our medical and pharmacy data, our programs work together to better identify care gaps and proactively reach out to members and their doctors for improved health outcomes.

Pharmacy Coverage

Combining medical and pharmacy can mean better outcomes and big savings.


When choosing pharmacy benefits, what should you focus on?

Having both medical and pharmacy benefits with Anthem enables us to better identify and close gaps in your employees’ health care – like when they aren’t filling prescriptions or missing lab tests.

Improved employee health¹, ²
  • 10% fewer hospital stays
  • 28% more care gaps found
  • 26% more care gaps closed³
Specialty pharmacy. Personal support.

What happens when nurses and pharmacists provide caring support and help for members? Improved medication adherence thanks to our specialty pharmacy programs.4

Targeted communication. Meaningful results.

Medication review mailings spotlight actions needed for drug safety, cost savings and adherence.

1 Integrated medical and pharmacy claims data vs. pharmacy data from a carve-out pharmacy benefit manager. Care gap outcomes for MyHealth Advantage using our pharmacy data compared to carve-out pharmacy data, compliance results based on 12-months clinical and cost-of-care programs for Commercial business, and reduction in hospital visits based on Anthem 2014 integrated analysis.

2 Results shown do not represent a guarantee of coverage or outcomes, and may not be representative for your group. Group-specific results/outcomes/cost savings will vary.

3 care gaps closed within 12 months

4 When compared to local retail pharmacies

We have pharmacy choices to match your goals. Want lots of local in-network pharmacies or the most drug list choices for employees? Done. Want to maximize savings? We’ve got that, too.

More retail pharmacy networks. More choices.
  • National Plus Network includes over 70,000 pharmacies across the US.
  • Rx Choice Tiered Network offers savings and over ~20,000 locations, plus even more in the National Plus Network.*
  • Retail 90 Network pharmacies can fill up to a 90-day supply of medications.
Drug lists to meet your needs.
  • National Drug List - broad drug list includes most generic and brand-name drugs.
  • Essential Drug List - drives savings by excluding drugs that have over-the-counter and/or formulary alternatives at a lower cost.

* Your employees have more pharmacy location choices when they pay a small additional fee.

Seamless and simplified, that’s the benefit of coordinated medical and pharmacy coverage.

Better for your business
  • A single account management team
  • One group application
  • One eligibility feed
  • One bill
Better for your employees
  • One enrollment application
  • One ID card
  • One website for all health care needs
  • One mobile app for medical & pharmacy
    (including mobile ID card)

Big savings. Big results. By combining our medical and pharmacy programs, employers could save up to $28 PMPM in medical and pharmacy costs.¹

Our programs work together and lead to:

Fewer hospital stays

Fewer ER visits

Lower medical costs

¹ 2014 internal analysis; savings correlation associated with members who have chronic conditions and are engaged in their health care and our programs. Results shown do not represent a guarantee of coverage or outcomes, and may not be representative for your group. Group-specific results/outcomes/cost savings will vary.

Anthem Pharmacy + Medical

Combine our programs to save money and improve health outcomes

Explore new insights
on integrated & specialty pharmacy benefits

Our latest research shows how employers can help manage costs and keep their employees healthy.

Sharon’s Story: medical + pharmacy in action

After multiple ER visits and hospital stays, a case manager is assigned to work with Sharon to help her improve her health. The case manager sees a care gap alert that shows Sharon is late in filling her Hepatitis C medication. Sharon's doctor is also alerted.
The case manager and the doctor help Sharon understand it’s necessary to take her Hepatitis C medication daily and complete all therapy to cure Hepatitis C. Sharon and her case manager create daily medication reminders so that Sharon successfully completes her treatment.
12 weeks later, Sharon sees her tests. She is happy to know she is now free of the Hepatitis C virus.
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Better for you.
Better for your employees.

With medical and pharmacy benefits from Anthem, your business will have seamless administration, streamlined enrollment and simplified claims. Your employees will enjoy more complete care that helps them stay healthy and on the job.

Ready to take the next step?