Walgreens to go out-of-network for Dayton-based plan

Walgreens will be out-of-network starting Jan. 1 for Ohioans with Medicaid plans through CareSource.

There are 1.2 million Ohioans covered through Dayton-based CareSource’s Medicaid plan.

Those members will need to get their prescriptions from a different pharmacy as of 2020 unless something changes and the two hash out an in-network contract.

The nonprofit insurer manages the largest Medicaid plan in Ohio; just over half of the Ohioans with health insurance through Medicaid have their plan through CareSource.

MORE: CareSource announces major business change

Walgreens is also one of the largest pharmacy chains in the area, listing 24 stores in the Dayton metro area. This summer the chain also bought the assets of several now-closed area pharmacies.

A Walgreens spokeswoman said Monday that CareSource “has decided to move forward with a network that does not include Walgreens for Ohio managed Medicaid patients in 2020.”

She said Walgreens is currently in-network for two other Medicaid plans in Ohio, UnitedHealthcare Community Plan and Paramount Advantage.

“CareSource continuously evaluates our provider network to ensure we are offering members excellent access to quality care,” Stephen Ringel, CareSource Ohio Market president. “We are in the process of reviewing our future plans with Walgreens with the Ohio Department of Medicaid and remain committed to meeting and exceeding all network access standards while also being good stewards of tax payer dollars.”

MORE: 5 local pharmacies have closed in recent months

The news comes as Medicaid open enrollment season nears. From Nov. 1 to Nov. 30, Ohioans covered by Medicaid plans managed by private insurance companies such as CareSource can decide whether to keep their plan or select a different one.

Ohio Department of Medicaid has resources for comparing Medicaid plans or for help with open enrollment at ohiomh.com or call 1-800-324-8680.

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