Switching from BCBS to Aetna, but staying on CVS Caremark. Do i need my specialty medication re approved?

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I am on a specialty medication (Humira) that I had to get pre-authorization for this year. Going thru CVS Caremark. My insurance is switching to Aetna next year and I was told the plan is more or less exactly the same as our BCBS plan now (and is will still be using CVS Caremark as prescription provider)

I totally assumed I’d have to get my Humira pre authorized again, but when I called someone at Accolade (someone who helps me with insurance questions), she surprisingly said the medication does not need to get pre approved again since I am sticking with Caremark. That Caremark makes that decision and not Aetna. Is that correct?? That sounds wrong, I feel like Aetna would totally have to pre approve it. What the hell does CVS caremark even do? I’ve been trying to understand PBMs for over a year now and I still dont get it

submitted by /u/pizzunk
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I am on a specialty medication (Humira) that I had to get pre-authorization for this year. Going thru CVS Caremark. My insurance is switching to Aetna next year and I was told the plan is more or less exactly the same as our BCBS plan now (and is will still be using CVS Caremark as prescription provider) I totally assumed I’d have to get my Humira pre authorized again, but when I called someone at Accolade (someone who helps me with insurance questions), she surprisingly said the medication does not need to get pre approved again since I am sticking with Caremark. That Caremark makes that decision and not Aetna. Is that correct?? That sounds wrong, I feel like Aetna would totally have to pre approve it. What the hell does CVS caremark even do? I’ve been trying to understand PBMs for over a year now and I still dont get it
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