VIRTUAL VISITS & PHARMACY (RX)
Anthem provides a lower cost alternative to care from the convenience of your home through virtual visits. See more information below on Anthem's virtual visits and prescription drug coverage.
VIRTUAL VISITS
LiveHealth Online & K Health
Anthem's medical insurance offers members access to virtual, urgent, and specialty care through LiveHealth Online and K Health. This includes virtual annual preventive care (wellness) visits.
All your virtual care will be provided through our Sydney Health app. After you log in to the app, you have several paths to choose from, depending on the type of care you need. Certain care and programs are handled by LiveHealth Online, and others by K Health. No matter what care you need, your starting point is always Sydney Health, and you can be confident in the quality of the care you will receive. To get started, on the homepage, select Care and then Virtual Care.
See below for a breakdown of different services available through LiveHealth Online & K Health.
A wide range of non-emergency conditions may be treated, including:
- Acne
- Allergies
- Cold & Flu
- Body Aches
- Constipation
- Cough
- Headaches
- Nausea
- Eye/Ear Infections
- Rash/Skin Irritations
- Respiratory Infections
- Sinus Infections
- Stomachache/Diarrhea
- Sore Throats
- Urinary Tract Infections
- Many other conditions
Want to see a member's experience with LiveHealth Online?
PRESCRIPTION (Rx) BENEFITS
Prescription benefits are automatically included as part of your medical plan options. This means if you enroll in one of the available Anthem medical plans, you are automatically provided with prescription drug coverage. Pharmacy benefits are administered by CarelonRx.
MAIL ORDER PROGRAM
Your medical plan includes a maintenance medication program. Maintenance medications are those taken for three months or longer to treat chronic conditions such as asthma, arthritis, high cholesterol, diabetes, heart disease and others. If you are taking these types of medications, you have two ways to fill your 90-day supply while saving money:
CarelonRx Pharmacy Home Delivery
Looking for an easier way to refill your prescriptions while also saving time? CarelonRx Pharmacy’s 90-day prescription benefit options help you get the medication you need with fewer trips to the pharmacy. The 90-day prescription benefit offered as part of your plan lets you choose to have medicines delivered to your door. You can also choose to pick up your medicines at a retail pharmacy. If you need any additional assistance with Home Delivery, you can contact 1-833-203-1739.
- Get up to a 90-day supply delivered to your home or pharmacy
- Reorder only once every three months online, by phone or mail
- Receive your medicine in private, secure packaging
MANDATORY GENERIC
For both medical plans, brand name drug prescriptions will be filled with a generic equivalent drug (should one be available). If you or your doctor want your prescription to be filled with the brand name version of the drug, your doctor must indicate this in writing on your prescription. If your doctor does not expressly request the brand version, you may request this from the pharmacist but you will be charged the applicable generic copay plus the difference in cost between the brand and its generic equivalent.
MANDATORY STEP THERAPY
Step Therapy is the practice of beginning drug therapy for a medical condition with the most cost-effective and safest drug and then progressing to other more costly drugs only if necessary (i.e., you must try drug “A” before you can get drug “B”). These alternative medications are used to treat the same conditions and often cost less. There are instances where you may have a medical necessity for a specific drug that would typically require Step Therapy. In these instances, your doctor can ask for a medical exception by contacting Anthem and providing the required clinical documentation.
