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Effective January 1, 2025, QualChoice will be making a change to its Pharmacy Benefits Manager (PBM). As of that date, Express Scripts (ESI) will be the new PBM for QualChoice members. Prior Authorizations (PAs) may be requested starting January 1, 2025, from ESI by any of the methods below. A general PA form and a copy of the 2025 Formulary is available at QualChoice.com on the Pharmacy page.
Members will receive a new QualChoice ID card before January, 1, 2025, and should be encouraged to share that new card with their pharmacy at their first fill of 2025 so they have the new processing information. See below for the timeline of the distribution of the new ID cards:
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New ID cards for groups with renewal dates of February through November will go out the last week of November.
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December renewals must be in house and fully processed by December 5 to ensure a December 9 postmark date.
- January renewals must be in house and fully processed by December 11 to ensure a December 16 postmark date.
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