Benefits & Wellness

Pharmacy

Pharmacy coverage is included with your Anthem medical premium however the coverage is administered by Alternative Reimbursement Opportunities for Rx (ARORx). ARORx focuses on assisting covered individuals in finding cost savings options for their high-cost medications (>$400 generic and >$1000 name brand). Some key points to know:

  • Members often receive these high-cost medications for FREE or at a low cost by using pharmacy assistance programs offered by drug manufacturers and international options through Canada
  • Members have access to all national pharmacy chains and most local pharmacies
  • ARORx uses an open formulary with no alterations to treatment paths
  • ARORx provides a concierge service that walks the members through the entire process

You can view the ARORx High Cost Drug List by clicking here. If one or more of your medications (or the medications of any covered member) are on this list, you will need to follow the High-Cost Drug Program steps below so ARORx can start finding savings options for you.

Medicare Part D Notification & Creditable Coverage Notice:

Medicare Part D, the Medicare prescription drug program, generally imposes a lifetime penalty for late enrollment if an individual delays enrolling in Part D after initial eligibility (for example, after reaching age 65), unless the individual continues to be covered by an employer's group medical plan because of active employment or COBRA, and coverage under the plan is "creditable" (meaning equal to or better than coverage provided under a Part D standard plan). Due to this, all employers are required to notify Medicare Eligible employees by October 15th of each year if the offered plan in "creditable" or "non-creditable". The coverage provided by Southern State Community College is considered Creditable Coverage. To view the notification requirements or the official creditable coverage notice please open the documents below.

Medicare Part D Notification Requirements

Compliance Packet

High-Cost Drug Program:

  • Step 1: If you are prescribed high-cost medication, call ARORx.
    • The pharmacy won't be able to fill your prescription until you work with ARORx.
  • Step 2: If you do not contact ARORx, they will contact you.
  • Step 3: Once you contact ARORx, they complete necessary paperwork only needing Employee signature.
  • Step 4: ARORx works directly with the employee's physician to complete the application.

ARORx partners with EVO to give you access to your plan & claims through their online portal. Each member and their spouse and/or dependents will have a separate account. From the portal you can shop your non-high cost and/or specialty drugs.

To get started on the EVO Portal:

  • Start at https://evofirst.com
  • Click register and enter basic information about yourself
  • You will get a confirmation code to your email to enter
  • Once confirmed you will have full access to the member portal